System and method for treating skin and underlying tissues for improved health, function and/or appearance

ABSTRACT

Systems and methods for treating facial soft tissues of a patient in a healthcare or cosmetic treatment environment such as, for example, a spa, clinic, or a medical practitioner&#39;s office are presented herein. The facial treatment system includes a facial stimulator instrument and/or an acoustic oscillator to deliver therapeutic stimulation to the facial tissues of a patient including percussive massage, electrical stimulation, and acoustic stimulation. A facial treatment application executing on a processor of a computing device identifies a treatment protocol and operates the facial stimulator instrument and/or acoustic oscillator to implement the facial tissue treatment.

CROSS-REFERENCE TO RELATED CASES

The present application is a continuation-in-part of InternationalApplication No. PCT/US2012/055551, which is entitled Systems and Methodsfor Treating Skin and Underlying Tissues for Improved Health, Functionand/or Appearance, with an international filing date of Sep. 14, 2012.The PCT application claims priority to U.S. Provisional PatentApplication No. 61/616,967, filed Mar. 28, 2012, and entitled System andMethod for Treating Skin and Underlying Tissues for Improved Health,Function and/or Appearance; and also claims priority to U.S. ProvisionalPatent Application No. 61/535,225, which is entitled Systems and Methodsfor Preventing and/or Treating Peripheral Neuropathy and PeripheralVascular Disease, and was filed Sep. 15, 2011.

This application also claims priority to U.S. Provisional PatentApplication No. 61/791,203, which is entitled System and Method forTreating Skin and Underlying Tissues for Improved Health, Functionand/or Appearance, and was filed Mar. 15, 2013.

The contents of all of the above-mentioned patent applications arehereby incorporated by reference in their entireties.

FIELD OF THE INVENTION

Aspects of the present invention relate to systems and methods relatedto skin health and beauty. More specifically, the present inventionrelates to medical systems and methods for treating facial soft tissuesof a patient in a healthcare or cosmetic treatment environment such as,for example, a spa, clinic, or a medical practitioner's office.

BACKGROUND OF THE INVENTION

The prevention or amelioration of the effects of aging on facial skin isa major focus of the health and beauty industry. In addition to theubiquitous beauty creams and other topical skin treatment compounds, anumber of other treatments attempt to address underlying causes ofwrinkling and loss of skin tone such as abnormal facial muscle tone,facial nerve anomalies, and disrupted circulation in the facialcirculatory vessels. Less invasive treatments to address theseunderlying causes include cosmetic acupuncture and facial toningtreatments such as active exercising of the facial muscles or passiveexercise of the facial muscles using electrostimulation of the facialmuscles. However, due to the lack of standardization of theadministration of these less invasive treatments, and the limitedability to assess the efficacy of these treatments, patients may opt formore invasive treatments that yield more dramatic and immediate results.

Invasive cosmetic procedures such as the injection of botulinum toxin(BOTOX®) into facial muscles as well as surgical procedures such as browlifts, eyelid lifts, face lifts, and collagen injections, areaccompanied by a significant risk inherent in any surgical procedure orinjection of a foreign substance. In addition, the effects of theseinvasive cosmetic procedures, for better or worse, are typically noteasily reversed, may be temporary, and may lead to long-term degradationof the facial tissues.

A need exists for a system and method of non-invasively treating facialtissues such as muscular, nervous, and circulatory tissues in astandardized manner using standardized diagnostic criteria. In addition,a need exists for a system and method of assessing the efficacy of afacial tissue treatment in a standardized and non-biased manner. Such asystem and method would overcome many of the current limitations ofnon-invasive facial treatment methods such as facial toning, and makepossible a safe and effective alternative to the invasive cosmeticsurgery methods commonly used to ameliorate the effects of aging on thefacial tissues.

BRIEF SUMMARY OF THE INVENTION

Disclosed herein is a system for treating a facial tissue of a patient.In one embodiment, the system includes a display and input device, atleast one camera, and at least one instrument chosen from a facialstimulator instrument and an acoustic oscillator. The facial stimulatoris configured to apply a percussive massage comprising one or more forceimpulses and/or an electrical stimulation comprising one or moreelectrical pulses to the facial tissue. The facial stimulator is furtherconfigured to measure a response of the facial tissue to one of theapplied force impulses or to one of the applied electrical pulses toassess a condition of the facial tissue. The acoustic oscillator isconfigured to apply an acoustic stimulation comprising one or moreacoustic pulses to the facial tissue of the patient.

In this embodiment, the system also includes at least one processor anda database. The database may include at least one stored treatmentprotocol, stored patient data, and at least one measurement-correlatedinstrument control setting. The stored patient data may include at leastone stored facial image; and at least one patient-specific treatmentprotocol.

The system in this embodiment further includes a facial treatmentapplication executed by the processor to obtain at least one facialimage using the at least one camera, to assess the symmetry of one ormore facial landmarks from the at least one facial image, and to selecta treatment protocol. The treatment protocol may include one or moreinstrument control settings, and one or more facial landmarks to betreated.

The facial treatment application may further implement one or moretreatments to the facial tissue according to one or more selectedtreatment protocols by operating one of the instruments using agraphical display to guide an operator of the system through thetreatment of the one or more facial landmarks. The one or moretreatments are chosen from a neural treatment, a muscular treatment, anda circulatory treatment. The neural treatment includes applying one ormore percussive massages and/or one or more electrical stimulations toone or more facial landmarks associated with facial nerves. The musculartreatment includes applying one or more percussive massages and/or oneor more electrical stimulations to one or more facial landmarksassociated with facial muscles. The circulatory treatment includesapplying one or more acoustic stimulations to one or more faciallandmarks associated with facial circulatory vessels.

Also disclosed herein is a method of treating a facial tissue of apatient. In one embodiment, the method includes obtaining at least onefacial image using at least one camera, assessing the symmetry of one ormore facial landmarks from the at least one facial image, and selectinga treatment protocol that includes one or more instrument controlsettings as well as one or more facial landmarks to be treated.

The method in this embodiment further includes implementing one or moretreatments to the facial tissue according to one or more selectedtreatment protocols by operating at least one instrument by using agraphical display to guide an operator through the treatment of the oneor more facial landmarks. The at least one instrument may be chosen froma facial stimulator instrument and an acoustic oscillator.

The one or more treatments implemented by the method in this embodimentinclude a neural treatment, a muscular treatment, and a circulatorytreatment. The neural treatment includes administering one or morepercussive massages and/or one or more electrical stimulations to one ormore facial landmarks associated with facial nerves. The musculartreatment includes administering one or more percussive massages and/orone or more electrical stimulations to one or more facial landmarksassociated with facial muscles. The circulatory treatment includesadministering one or more acoustic stimulations to one or more faciallandmarks associated with facial circulatory vessels.

Further disclosed herein is a second embodiment of a system for treatinga facial tissue of a patient, including memory, at least one camera, atleast one instrument, and a plurality of modules executing on at leastone processor. The memory includes at least one stored treatmentprotocol, stored patient data, and at least one measurement-correlatedinstrument control setting. The stored patient data includes at leastone stored facial image and at least one patient-specific treatmentprotocol.

The at least one instrument may include a facial stimulator instrumentto apply a percussive massage comprising one or more force impulsesand/or an electrical stimulation comprising one or more electricalpulses to the facial tissue. The facial stimulator instrument alsomeasures a response of the facial tissue to one of the applied forceimpulses or to one of the applied electrical pulses to assess acondition of the facial tissue. The at least one instrument may alsoinclude an acoustic oscillator to apply an acoustic stimulationcomprising one or more acoustic pulses to the facial tissue.

The plurality of modules includes a treatment protocol selection module,a neural treatment module, a muscular treatment module, and acirculatory treatment module. The treatment protocol selection moduleselects one or more treatment protocols based on at least one of: thestored patient data, an analysis of the condition of the facial tissues,one or more of the stored treatment protocols, one or more of the storedpatient-specific treatment protocols, and a treatment protocol specifiedby the operator. The neural treatment module implements a neuraltreatment comprising one or more percussive massages and/or one or moreelectrical stimulations to one or more facial landmarks associated withfacial nerves. The muscular treatment module implements a musculartreatment comprising one or more percussive massages and/or one or moreelectrical stimulations to one or more facial landmarks associated withfacial muscles. The circulatory treatment module implements acirculatory treatment comprising one or more acoustic stimulations toone or more facial landmarks associated with facial circulatory vessels.

Disclosed herein is a system for cosmetically treating tissue of apatient for at least one of improving skin appearance, reducing skinwrinkles, improving skin tone, or improving tissue function. In oneembodiment the system includes a display, an input, a CPU, a memory, afirst RF head, a RF receiver antenna, a plurality of second RF heads,and an EMG sensor. The display includes a LCD or other type of screenand is configured to display information associated with the treatmentof the tissue. The input is in electrical communication with the displayand includes a key board, touch screen, or other type of inputmechanism. The input is configured to receive information associatedwith the treatment of the tissue. The CPU is in electrical communicationwith the input. The memory is in electrical communication with the CPUand includes treatment parameters associated with the treatment of thetissue. The first RF head is capable of being placed in electricalcommunication with the CPU and includes an array of piezoelectrictransducers. The array is configured to generate RF over a range offrequencies not possible via a single piezoelectric transducer. The RFreceiver antenna is capable of being placed in electrical communicationwith the CPU and is configured to detect RF energy transmitted throughthe tissue from the first RF head. For the plurality of second RF heads,each second RF head has a piezoelectric transducer tuned to a uniquefrequency and is capable of being placed in electrical communicationwith the CPU. The EMG sensor is capable of being placed in electricalcommunication with the CPU and is configured to detect electromyogram inthe tissue. When the first RF head and RF receiver antenna are appliedto the tissue, the system is configured to: a) cause the first RF headto administer RF energy to the tissue over a range of RF frequencies; b)cause the RF receiver antenna to sense the administered RF energytransmitted through the tissue; c) identify which RF frequency of therange of RF frequencies administered to the tissue has the mosttransmissibility through the tissue; and d) recommend a second RF headof the plurality of RF heads that is capable of providing the identifiedRF frequency. When the recommended second RF head and EMG sensor areapplied to the tissue, the system is configured to: a) cause therecommended second RF head to administer RF energy at the identified RFfrequency to the tissue over a range of pulse frequencies; b) cause theEMG sensor to detect electromyogram in the tissue arising due to the RFenergy administered to the tissue over the range of pulse frequencies;c) identify which pulse frequency of the range of pulse frequenciesadministered to the tissue causes the highest electromyogram readings inthe tissue; and d) treat the tissue with the recommended second RF headat the identified RF frequency at the identified pulse frequency.

Depending on the version of the embodiment of the system, the array isconfigured to generate RF over a range of between approximately 500 KHzand approximately 1.5 MHz at, for example, steps of betweenapproximately 50 KHz and approximately 200 KHz.

In one version of the embodiment of the system, the piezoelectrictransducers of the array include a first piezoelectric transducer, asecond piezoelectric transducer, and a third piezoelectric transducer,wherein each of the first, second and third piezoelectric transducersgenerate RF at distinct frequencies from each other. In one version ofthe embodiment of the system, the plurality of second RF heads includesindividual second RF heads each tuned to a unique frequency from eachother and each unique frequency is between approximately 500 KHz andapproximately 1.5 MHz.

In one version of the embodiment of the system, when the recommendedsecond RF head is caused to administer RF energy at the identified RFfrequency to the patient over a range of pulse frequencies, the range ofpulse frequencies is between approximately 1 Hz and approximately 300Hz. In one version of the embodiment of the system, the recommendedsecond RF head is caused to administer RF energy at the identified RFfrequency to the patient over the pulse frequency range of betweenapproximately 500 KHz and approximately 1.5 MHz at stepsprogrammatically controlled and optimized for tissue type via storedprotocols.

In one version of the embodiment of the system, the system furtherincludes an impulse head capable of being placed in electricalcommunication with the CPU and including a solenoid driven anvilconfigured to deliver mechanical impulse energy to the tissue. Theimpulse head further includes a transducer sensor for detecting a wavegenerated in the tissue via the administration of the mechanical impulseenergy to the tissue.

In one version of the embodiment of the system, the system furtherincludes an electrode capable of being placed in electricalcommunication with the CPU and configured to administer electricalstimulation to the tissue and read electrical characteristics of thetissue in response to the electrical stimulation. The electrode may besupported on the impulse head.

In one version of the embodiment of the system, the system furtherincludes a camera capable of being placed in electrical communicationwith the CPU and configured to take images of the tissue. The system isconfigured to compare images of the tissue taken pre and post treatmentvia the system.

Also disclosed herein is a method for cosmetically treating tissue of apatient for at least one of improving skin appearance, reducing skinwrinkles, improving skin tone, or improving tissue function. In oneembodiment, the method includes: administering RF energy to the tissueover a range of RF frequencies; detecting the administered RF energy;identifying which RF frequency of the range of RF frequencies has thegreatest transmissibility through the tissue; recommending theidentified RF frequency for use in further RF energy treatment to thetissue; administering the RF energy at the identified RF frequency tothe tissue over a range of pulse frequencies; identifying which pulsefrequency of the range of pulse frequencies results in the highestelectromyogram readings in the tissue; recommending the identified pulsefrequency for use in further RF energy treatment to the tissue; andadministering the RF energy at the identified RF frequency andidentified pulse frequency to the tissue.

In one version of the embodiment of the method, the administration ofthe RF energy to the tissue over the range of frequencies isaccomplished via a RF head having an array of piezoelectric transducerseach tuned to an individual unique frequency, the array being configuredto generate RF over a range of between approximately 500 KHz andapproximately 1.5 MHz.

In one version of the embodiment of the method, the administration ofthe RF energy to the tissue over the range of frequencies is over arange of between approximately 500 KHz and approximately 1.5 MHz atsteps of between approximately 50 KHz and approximately 200 KHz.

In one version of the embodiment of the method, the recommending theidentified RF frequency for use in further RF energy treatment to thetissue includes identifying a specific RF head from a plurality of RFheads that is configured to provide the recommended RF frequency.

In one version of the embodiment of the method, the administering the RFenergy at the identified RF frequency to the tissue over a range ofpulse frequencies occurs over a pulse frequencies ranging betweenapproximately 1 Hz and approximately 300 Hz programmatically controlledand optimized for tissue type via stored protocols.

In one version of the embodiment of the method, the administering the RFenergy at the identified RF frequency to the patient over a range ofpulse frequencies occurs over a pulse frequencies ranging betweenapproximately 1 Hz and approximately 30 Hz.

While multiple embodiments are disclosed, still other embodiments of thepresent disclosure will become apparent to those skilled in the art fromthe following detailed description, which shows and describesillustrative embodiments of the disclosure. As will be realized, theinvention is capable of modifications in various aspects, all withoutdeparting from the spirit and scope of the present disclosure.Accordingly, the drawings and detailed description are to be regarded asillustrative in nature and not restrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a block diagram of a facial treatment system.

FIG. 2 is a block diagram of a facial treatment application configuredto operate on a computing device.

FIG. 3 is a block diagram of a stored treatment protocol selectionmodule of a facial treatment application.

FIG. 4 is a flow chart illustrating an embodiment of a stored treatmentprotocol selection module.

FIG. 5 is a block diagram of a facial symmetry assessment module of afacial treatment application.

FIG. 6 is a 2D facial image including a superimposed grid.

FIG. 7 is a block diagram of a 2D guided image analysis module.

FIG. 8 is an embodiment of a facial image display.

FIG. 9 is a 3D facial image.

FIG. 10 is a flow chart illustrating an embodiment of a facial symmetryassessment module.

FIG. 11 is a block diagram of a trigger point analysis module.

FIG. 12 is a flow chart illustrating an embodiment of a trigger pointanalysis module.

FIG. 13 is a block diagram of a neural treatment module.

FIG. 14 is an embodiment of a neural treatment guidance display.

FIG. 15 is a flow chart illustrating an embodiment of a neural treatmentmodule.

FIG. 16 is a block diagram of a muscular treatment module.

FIG. 17 is an embodiment of a muscular treatment guidance display.

FIG. 18 is a flow chart illustrating an embodiment of a musculartreatment module.

FIG. 19 is a block diagram of a circulatory treatment module.

FIG. 20 is an embodiment of a circulatory treatment guidance display.

FIG. 21 is a flow chart illustrating an embodiment of a circulatorytreatment module.

FIG. 22 is a cross-sectional side view of a facial stimulatorinstrument.

FIG. 23 is a diagrammatic depiction of a database for selecting atreatment protocol based on a diagnosis of a facial tissue disorder.

FIGS. 24A-24D are diagrams of embodiments of probes for a facialstimulator instrument.

FIG. 25 shows a computer screen depicting a waveform and derivedwaveform data.

FIG. 26 is a cross-sectional side view of an acoustic oscillator.

FIG. 27 is a diagrammatic depiction of a database containing storedinstrument control settings associated with the implementation of anelectrical stimulation as a function of the frequency response of afacial tissue to an applied force impulse.

FIG. 28 is a diagrammatic depiction of a database containing storedinstrument control settings associated with the implementation of anelectrical stimulation as a function of the measured change in galvanicresponse in reaction to an applied electrical stimulus.

FIG. 29 is a schematic diagram of an alternative embodiment of thesystem being used on the patient.

FIG. 30 is a schematic diagram of the system employing the evaluation RFhead and the RF antenna for the embodiment of the system depicted inFIG. 29.

FIG. 31 is a schematic diagram of the system embodiment of FIG. 29,wherein the selected treatment RF head and EMG sensor are coupled to thesystem and being applied to the patient.

FIG. 32 is a schematic diagram of the system employing the selectedtreatment RF head and the EMG sensor for the embodiment of the systemdepicted in FIG. 29.

FIG. 33 is a flow chart illustrating an operational method associatedwith the system embodiment of FIG. 29.

FIG. 34 is a graph of RF energy being administered at an exampleidentified (optimum) RF frequency and pulsed at an example identified(optimum) pulse frequency.

FIG. 35 is an example of a pulsed output signal similar to that depictedin FIG. 34.

FIG. 36 is an example of a modulated output signal.

FIG. 37 is a schematic diagram of the system employing both the clinicaland home-use portions connected by a network.

FIG. 38 is a schematic diagram of the system employing both the clinicaland home-use portions connected by an intermediary device.

FIG. 39 is a flow chart illustrating a procedure for administering afacial treatment involving percussive therapy of a nerve delivered witha facial stimulator instrument.

FIG. 40 is a flow chart illustrating a procedure for administering afacial treatment involving percussive therapy of a muscle delivered witha facial stimulator instrument.

FIG. 41 is a flow chart illustrating a procedure for administering afacial treatment with an acoustic oscillator.

FIG. 42 depicts front and side view of a patient's face with thelocation of trigeminal nerve exit points depicted thereon.

FIG. 43 depicts a side view of the patient's head with the anatomicalrouting of the trigeminal nerve.

FIG. 44 depicts a front view of a patient's face with the location offacial muscle connection points depicted thereon.

Corresponding reference characters and labels indicate correspondingelements among the views of the drawings. The headings used in thefigures should not be interpreted to limit the scope of the claims.

DETAILED DESCRIPTION

Disclosed herein is a system and method for assessing and treating thefacial tissues of a patient including, but not limited to: facialnerves, muscles, connective tissues, and circulatory vessels. In anaspect, the system is configured to provide one or more treatments tothe facial tissues of the patient in the form of: percussive massage,electrical stimulation, acoustic stimulation, and any combinationthereof. In other aspects, the system may be further configured toobtain one or more assessments of the condition of the facial tissuesbefore and/or after one or more treatments, and to store theseassessments in a database. These stored assessments may be used in anaspect to assess the efficacy of one of one or more treatments, tomonitor changes in the facial tissues over time, and to inform theselection of subsequent treatments. In various embodiments of thesystem, a treatment may be selected using one or more methods including,but not limited to: selecting a treatment from a predefined menu oftreatment protocols, determining a treatment based on an analysis of thecondition of the facial tissues of the patient, selecting a treatmentfrom a predefined menu of patient-specific treatment protocols, orspecifying a user-defined protocol for a treatment.

In one aspect, the facial treatment system may be used to maintainand/or enhance the health and appearance of facial tissues. Non-limitingexamples of aspects of the health and appearance of facial tissues thatmay be treated using the facial treatment system include: changes inappearance related to aging and erosion of subdermal fat includingthinning of the skin, loss of elasticity and tone of skin, drooping ofmouth corners, and formation of jowls; wrinkles including horizontalforehead lines, glabellar frown lines, crow's feet, perioral lines,marionette folds, and platysma bands; and changes or irregularities inskin coloration due to cutaneous conditions such as rosacea ordermatitis. In other aspects, the facial treatment system may be used totreat a variety of disorders afflicting one or more of the facialtissues. Non-limiting examples of disorders that may be treated usingthe facial treatment system include: strabismus, blepharospasm,hemifacial spasm and other facial muscle spasms, facial muscle weakness,loss of reciprocal inhibition of facial muscles, decreased movementcontrol, facial muscle hypertonicity, hyperhidrosis, chronic migraines,TMJ pain disorders, trigeminal neuralgia, post-herpetic neuralgia,facial nerve injuries including neuropraxia, neurotmesis, andaxonotmesis; Bell's palsy, facial nerve paralysis; facial tissueabnormalities associated with systemic disorders such as musculardystrophy, cerebral palsy, and Ramsay Hunt syndrome (RHS) type 2,sensory anomalies associated with facial nerve dysfunction such astinnitus or taste disorders; central facial palsy, dysarthria, facialsynkinesis, hyperlacrimation, orofacial myological disorders such astongue thrust, oropharyngeal dysphagia, speech disorders associated withabnormal facial muscle tone, atypical facial pain (AFP), facial tics,and herpes zoster oticus.

Aspects of the facial treatment system described herein providestandardized and repeatable treatment protocols for the facial tissuesof a patient, and further provide the ability to obtain and storeinformation related to the condition of the facial tissues before,during, and after a treatment. This information allows the operator tomonitor the efficacy of the treatment both immediately after thetreatment, as well as after the passage of time between treatments; thisinformation may further inform the selection of a treatment protocoland/or dynamically adjust the protocol during the administration of atreatment.

Detailed descriptions of embodiments of the facial treatment system,devices included in the facial treatment system, and methods of usingthe facial treatment system are provided herein below.

I. Facial Treatment System

The elements of a facial treatment system 100 are depicted in FIG. 1.The system 100 includes a computing device 102, one or more cameras 104,a facial stimulator instrument 106, and an acoustic (RF) oscillator 108.Non-limiting examples of a suitable computing device include a laptopcomputer, a personal digital assistant, a tablet computer, a standardpersonal computer, or any other known processing device. The computingdevice 102 includes one or more processors and memory configured tosend, receive, and process data and/or communications from an operatorof the system 100, the one or more cameras 104, the facial stimulatorinstrument 106, and the acoustic oscillator 108 in order to assess thecondition of the facial tissues of a patient 110, select a treatmentprotocol, and implement a treatment of the facial tissues of the patient110.

The one or more cameras 104 are configured to obtain facial images ofthe patient 110 that may be used to assess the condition of the facialtissues before, during, and/or after a treatment. The facial stimulatorinstrument 106 is configured to deliver a plurality of percussive shockwaves and/or a plurality of electrical pulses to the facial tissues ofthe patient 110 during the course of a treatment. The facial stimulatorinstrument 106 is further configured to measure characteristics of thefacial tissue of the patient 110, such as tissue reactive force duringthe application of a percussive shock wave, or tissue galvanic responseduring the application of an electrical pulse. The acoustic oscillator108 is configured to deliver acoustic pulses to the facial tissues of apatient during the course of a treatment. The one or more cameras 104,the facial stimulator instrument 106, and the acoustic oscillator 108are further configured to receive data and/or communications from thecomputing device 102 in order to operate the devices in a coordinatedmanner during the implementation of a treatment by the system 100.

The computing device 102 includes a display 112 configured to displaydata and/or graphical user interfaces (GUIs) 116 to the operator.Non-limiting examples of devices suitable for use as a display 112include a computer monitor and a touch screen. The computing device 102may further include an input device 114 including, but not limited to, akeyboard and/or a pointing device such as a mouse, a trackball, a pen,or a touch screen. The input device 114 is configured to enter data intoor interact with the GUIs 116 used to implement the operation of thesystem 100. In an embodiment, the display 112 and input device 114 maybe a single integrated device, such as a touch screen. The GUI 116enables the operator of the system 100 to interact with menus and otherdata entry forms used to control the operation of the system 100.

The computing device 102 further includes a facial treatment application120 configured to receive and process data and/or communications, aswell as produce and send data and/or communications used to perform thefunctions of the system 100 described herein above, and in detail hereinbelow. The data and/or communications produced by the facial treatmentapplication 120 may be sent to the display 112 in order to guide theoperator of the system 100 through the functions of the system 100. Inaddition, the data and/or communications may be sent to the one or morecameras 104, the facial stimulator instrument 106, and/or acousticoscillator 108 in order to operate these devices in a coordinated mannerduring the operation of the system 100.

The computing device 102 further includes a database 122 configured tostore a plurality of stored treatment protocols 124, stored patient data126, and measurement-correlated instrument control settings 132. Thestored treatment protocols 124 may include data utilized during theimplementation of one or more treatments to the patient 110 using thesystem 100. For example, one of the stored treatment protocols 124 mayinclude parameters used for the implementation of a treatment such asthe location of the treatment on the facial tissues of the patient 110and instrument operating parameters such as a power setting or aduration of instrument operation. The stored patient data 126 mayinclude patient-specific information used to monitor the condition ofthe facial tissue of the patient 110 over time, to maintain a record ofprevious treatments performed by the system 100, to provide a scheduleof future treatments, and to perform a customized treatment on aparticular patient 110 using the system 100. The stored patient data 126may include stored facial images 128 obtained by the system 100 usingthe one or more cameras 104. The stored patient data 126 may furtherinclude patient-specific treatment protocols 130 that may includeparameters used for the implementation of a treatment that arecustomized for the treatment of a particular patient 110 based on aprevious assessment of the condition of the facial tissues of thepatient 110 and/or previous treatments performed on a particular patient110 using the system 100.

II. Facial Treatment Application

FIG. 2 is a block diagram depicting a facial treatment application 120Aexecuting on a computing device 102A. According to one aspect, thecomputing device 102A includes a processing system 202 that includes oneor more processors or other processing devices. The processing system202 executes the facial treatment application 120A to select and providea treatment of the facial tissues of a patient 110 (not shown) using thefacial stimulator instrument 106 (not shown) and/or acoustic oscillator108 (not shown). The facial treatment application 120A may furtherobtain and analyze facial images of the patient 110 using one or morecameras 104 (not shown) to assess the condition of the patient's facialtissues. A database 122 may be accessed by the facial treatmentapplication 120A during execution to provide information including, butnot limited to: stored facial images and other stored patientinformation, stored treatment protocols, and stored instrument controlsettings.

In an aspect, the computing device 102A includes a computer readablemedium (“CRM”) 204 configured with the facial treatment application120A. The facial treatment application 120A includes instructions ormodules that are executable by the processing system 202 to enable auser to implement a treatment to the facial tissues of a patient 110.

The CRM 204 may include volatile media, nonvolatile media, removablemedia, non-removable media, and/or another available medium that can beaccessed by the computing device 102A. By way of example and notlimitation, computer readable medium 204 comprises computer storagemedia and communication media. Computer storage media includesnontransient memory, volatile media, nonvolatile media, removable media,and/or non-removable media implemented in a method or technology forstorage of information, such as computer readable instructions, datastructures, program modules, or other data. Communication media mayembody computer readable instructions, data structures, program modules,or other data and include an information delivery media or system.

A GUI module 206 transmits one or more GUIs 116 (not shown) to thedisplay 112 (not shown). As described above, the operator of the system100 interacts with one or more GUIs received from the computing device102A to review treatment protocols, enter data and make menu selectionsused to implement a treatment using the system 100. Examples of screenshots of the one or more GUIs 116 in various aspects are provided hereinbelow.

In an aspect, the facial treatment application 120A includes a treatmentprotocol selection module 208 for selecting an appropriate treatmentprotocol based on stored patient data, analysis of the patient's facialtissues, selection from a stored menu of treatment protocols, and/orspecification of a treatment protocol by the operator of the system 100.The facial treatment application 120A may further include modules toimplement a particular treatment on the facial tissues of a patient,including a neural treatment module 216, a muscular treatment module218, and a circulatory treatment module 220. Detailed descriptions ofeach of the modules of the facial treatment application 120A areprovided herein below.

III. Treatment Protocol Selection Module

The treatment protocol selection module 208 selects one or moretreatment protocols to be performed on the facial tissues of a patient110. The one or more treatment protocols may be selected from a storedmenu of treatment protocols, a treatment protocol may be determinedbased on an assessment of the condition of the patient's facial tissues,or a treatment protocol may be specified by the operator of the system100A. The treatment protocol selection module 208 in an embodiment mayinclude a stored treatment protocol module 210, a facial symmetryassessment module 212, and an operator-selected treatment module 214.

a. Stored Treatment Protocol Module

The stored treatment protocol module 210 is configured to generate amenu of treatment protocols from which the operator may select atreatment for the facial tissues of the patient, as well as to implementthe treatment protocol selected from the menu by the operator. In anembodiment, illustrated in FIG. 3, the stored treatment protocol module210 may include a treatment protocol selection module 302, an instrumentcontrol settings module 304, and a treatment selection module 306. Thetreatment protocol selection module 302 generates a menu of treatmentprotocols and displays this menu to the operator via the GUI 116 (notshown). The menu of treatment protocols may be a list of standardtreatments arranged into one or more organizational schemes including,but not limited to: region of face, type of facial tissue, type offacial tissue disorder, treatments previously performed on the patient,desired results of a facial tissue treatment, and a schedule of plannedtreatments for a patient. In an embodiment, the stored treatmentprotocol module 210 may access stored patient information from thedatabase 122 (not shown) in order to generate the menu ofpatient-specific treatment protocols. For example, the stored treatmentprotocol module 210 may retrieve one or more patient-specific treatmentprotocols 130 from the database 122, shown on FIG. 1, for use in themenu of treatment protocols.

Referring back to FIG. 3, the stored treatment protocol module 208 mayfurther include an instrument control settings module 304 configured todetermine the appropriate settings for one or more instruments used toimplement a treatment protocol selected by the operator from the menu oftreatment protocols using the treatment protocol selection module 302.As illustrated in FIG. 1, the system 100 may administer treatments withone or more instruments including, but not limited to, a facialstimulator instrument 106 and an acoustic oscillator 108. In anembodiment, the instrument control settings module 304 may determine oneor control settings for the facial stimulator instrument 106 including,but not limited to: preload tissue compression force, magnitude andfrequency of a percussive impact, as well as power and waveform of anelectrical stimulation to be applied to the facial tissue. In anotherembodiment, the instrument control settings module 304 may determine oneor control settings for the acoustic oscillator 108 including, but notlimited to: magnitude and frequency of an acoustic pulse to be appliedto the facial tissue. A more detailed description of additionalinstrument control settings that may be determined by the instrumentcontrol settings module 304 are provided herein below.

The stored treatment protocol module 208 may further include a treatmentselection module 306. Once the treatment protocol has been determined bythe treatment protocol selection module 302 and the instrument controlsettings have been initialized by the instrument control settings module304, the treatment selection module 306 may initiate the execution ofone or more of the treatment modules used to implement a treatment on amuscular facial tissue, a facial nerve, and/or a facial circulatoryvessel.

FIG. 4 is a flow chart illustrating a series of actions taken by theoperator of the system in an embodiment of the stored treatment protocolmodule 208. In this embodiment, the operator of the system makes aselection to access the stored treatment protocol database at step 402.The operator then selects a desired treatment protocol from thedisplayed list of stored treatment protocols at step 404. Once atreatment protocol has been selected, the operator then selects one ofthe treatment modules for execution at step 406. At step 406, thetreatment modules available for execution are limited by the storedtreatment protocol module 208 to include only those treatment modulesthat are appropriate for the selected treatment protocol.

b. Facial Symmetry Assessment Module

Referring back to FIG. 2, the facial treatment application 120 furtherincludes a facial symmetry assessment module 212 configured to assessthe condition of the facial tissues of the patient and determine arecommended treatment protocol based on the assessed condition of thefacial tissues. The facial symmetry assessment module 212 may analyzeone or more facial images obtained by a 2D or 3D camera (not shown) inorder to assess the degree of symmetry between corresponding left andright facial features or facial landmarks. In this embodiment, if theanalysis of the one or more facial landmarks indicates sufficientasymmetry between corresponding left and right facial landmarks, thefacial treatment application 120 may recommend one or more treatmentprotocols involving facial tissues associated with the asymmetricalfacial landmark.

FIG. 5 is a block diagram illustrating an embodiment of the facialsymmetry assessment module 212. In this embodiment, the facial symmetryassessment module 212 may include a 2D facial symmetry assessment module502 configured to obtain and analyze facial images using a 2D camera.The facial symmetry assessment module 212 may further include a 3Dfacial symmetry assessment module 504 configured to obtain and analyzefacial images using a 3D camera. A trigger point analysis module 506 mayimplement further assessment of selected facial tissues identified bythe 2D facial symmetry assessment module 502 or 3D facial symmetryassessment module 504 using other instruments (not shown) such as thefacial stimulator instrument 106 and/or the acoustic oscillator 108.Once a recommended treatment protocol has been identified, theinstrument control settings module 508 provides the appropriateinstrument control settings and the treatment selection module 510directs the initiation of one or more treatment protocols. The 2D and/or3D facial images obtained before and/or after treatment, as well as anyassociated patient data and/or treatment protocol information may bestored in the database 206 (not shown) by the facial image storagemodule 512.

i. 2D Facial Symmetry Assessment Module

The 2D facial symmetry assessment module 502 may include a 2D imageacquisition module 514 configured to obtain a 2D facial image of thepatient. A 2D camera interface module 516 may operate the camera via theinput device 114 and display 112 to obtain the 2D facial image. Thepatient is placed in a fixed position and a 2D image may be obtainedusing inputs from the operator captured via a GUI or other interface onthe input device 114. The positioning of the patient's face within theframe of the facial image, the degree of brightness and/or contrast, theresolution of the obtained image, and any other parameters relevant tothe 2D facial image may be determined automatically by the 2D imageacquisition module 514. Alternatively, the 2D image acquisition module514 may generate a GUI 116 (not shown) configured to guide the operatorthrough the acquisition of a 2D image of the patient's face. The 2Dfacial image 600 of the patient may include a superimposed grid 602, asillustrated in FIG. 6, to aid in the analysis of facial symmetry of thepatient.

A standard 2D facial image may be obtained by placing the patient in astandard position using known methods such as immobilizing the patient'shead in a standardized chair or rig. In a standard 2D facial image, thescaling of distances between facial landmarks in the facial image andthe actual distances is a known standard scale; in addition, thehorizontal and/or vertical orientation of the facial image may beobtained in a standardized and repeatable manner. Alternatively, anon-standard 2D facial image may be obtained without the use ofstandardized rigs. The non-standard 2D facial image may further containscaling elements such as rulers or reference lines within the backgroundof the 2D facial image. Known image processing techniques such asscaling and axis rotation may be used to convert a non-standard 2Dfacial image into a standard 2D facial image to facilitate subsequentanalysis. In yet another embodiment, relative displacements of thefacial landmarks may be used to assess facial symmetry, obviating theneed to obtain a standardized 2D facial image. For example, theseparation of the pupils of the eye as a fraction of the maximum headwidth may be used as a relative measurement.

The 2D facial symmetry assessment module 502 may further include a 2Dimage analysis module 518 configured to assess the symmetry of selectedfacial landmarks from the 2D facial image. A 2D guided image analysismodule 520 may perform an analysis of the 2D facial image by guiding theoperator through a series of image analysis steps via a GUI 116 (notshown). An automated assessment of the 2D facial image may also beperformed using the 2D automated image analysis module 522. In variousembodiments, a guided image analysis and/or an automated image analysismay be performed on the 2D facial image. In an aspect, the 2D automatedimage analysis module 522 may automatically identify and compare faciallandmarks to determine asymmetries in a manner similar to the methodsimplemented by the analysis modules of the 2D guided image analysismodule 520, described herein below. In another aspect, the 2D facialsymmetry assessment module 502 may assess the symmetry of selectedfacial landmarks using a combination of a guided image analysis and anautomated analysis.

FIG. 7 is a block diagram illustrating an embodiment of the 2D guidedimage analysis module 520. In this embodiment, the operator identifiesat least one facial landmark on a 2D facial image displayed within anfacial image analysis GUI 800 (not shown) generated by a facial imageinterface module 702. Facial landmarks, as defined herein, refer tofacial features that are identifiable from a facial image that may beused in the assessment of facial symmetry. Non-limiting examples offacial landmarks include: an eye feature such as a pupil, an iris, alateral corner, or a medial corner, or an eyebrow; an ear feature suchas an earlobe (lobule), a helix, or a tragus; a nose feature such asbridge of a nose, a nostril, or a tip of a nose; a chin or jaw featuresuch as chin cleft or a mandibular joint; a mouth feature such as amouth corner; a forehead feature; a facial wrinkle; or any other facialfeature that is readily located on a 2D or 3D facial image.

An example of an image analysis GUI 800 generated by the facial imageinterface module 702 is illustrated in FIG. 8. In this example, theoperator has identified a facial landmark 802 on the 2D facial image 600corresponding to the bottom of the patient's right earlobe. The faciallandmarks identified by the operator may be represented as a dot orother symbolic representation including, but not limited to, a square orother geometric shape, a cross-hair, or any other representation easilyvisible by the operator. The image analysis GUI 800 may also include oneor more control buttons 804A-804K that may be activated to perform adesired action associated with the acquisition and analysis of a 2Dimage. The control buttons 804A-804K may be activated and/or deactivatedusing any known user input method including clicking on the controlbutton using a mouse-type input device, and/or touching a control button804 displayed on a touch screen input device.

As shown in FIG. 8, the control buttons 804A-804K may control a varietyof functions associated with the guided 2D image analysis. A 2D imagemay be acquired using the 2D camera or a stored facial image may beretrieved from the database by activating control buttons 804H and 804K,respectively. The operator may sequentially identify additional faciallandmarks by activating control button 804A. An operator-selected faciallandmark, such as the bottom of the right earlobe 802, may be revised byactivating control button 8041, or all operator-selected faciallandmarks may be revised by activating control button 804K. A history ofall operator-identified facial landmarks may be displayed by activatingcontrol button 804D and the current image analysis GUI 800 may beprinted by activating control button 804E. The operator may continue onto the assessment of facial symmetry by activating control button 804C,cancel the execution of the 2D image analysis module by activatingcontrol button 804E, or exit from the facial treatment application 120altogether by activating control button 804G.

Referring back to FIG. 7, the 2D guided image analysis module 704further includes a number of analysis modules 704-718 configured tocompare the facial landmarks identified by the operator using the facialimage interface module 702 and assess the symmetry of corresponding leftand right facial landmarks. For example, the facial landmark 802associated with the bottom of the patient's left earlobe may be comparedto the facial landmark associated with the bottom of the patient's rightearlobe to assess the symmetry of the patient's earlobes.

A reference axis assignment module 704 may determine a location on the2-D image corresponding to a reference axis. A reference axis may beused to provide a standard geometrical reference from which alldistances such as height or lateral separation from a facial axis ofsymmetry may be determined. For example, the patient's nose centerlinemay be assigned to a reference vertical axis, and a line perpendicularto the patient's nose centerline may be assigned to a referencehorizontal axis. Other facial landmarks of the patient including, butnot limited to, eye pupils or any other operator-identified faciallandmarks may be used to establish one or more reference axes. Thereference axes may be assigned relative to the patient's face, asdiscussed herein above, or relative to an absolute horizontal and/orvertical axis. For example, the patient's facial image may include areference scale, such as a ruler oriented horizontally and/or a ruleroriented vertically. In this example, the distances separating faciallandmarks may be expressed in terms of absolute distances, and/or interms of distances relative to other landmark features. For example, thelocation of the bottom of the right earlobe may be expressed as ahorizontal and vertical distance in cm relative to an origin specifiedby the operator. Alternatively, the location of the bottom of the rightearlobe may be expressed as a relative distance such as the % of thepupil separation distance. Any known reference axis system including,but not limited to, a Cartesian coordinate system, a polar coordinatesystem, and a conformal grid coordinate system may be used in the system100.

An eye comparison module 706 compares the location of a facial landmarkassociated with the left eye and the location of a facial landmarkassociated with the right eye of the patient. For example, the eyecomparison module 706 may compare the lateral distance of the rightpupil and the left pupil relative to the bridge of the nose. In anotherexample, the location of the corners of the left eye relative to theleft eyebrow may be compared to the locations of the right eye cornersrelative to the right eyebrow. In yet another example, the location andextent of the skin flap above the left and right eyelids may becompared. In another additional example, the corneal reflectivity of theleft and right eyes may be compared.

An ear comparison module 708 compares the location of a facial landmarkassociated with the left ear and the location of a facial landmarkassociated with the right ear of the patient. For example, the locationof the left and right earlobe of the patient may be compared.

A cheek assessment module 710 compares the location of a facial landmarkassociated with the left cheek and the location of a facial landmarkassociated with the right cheek of the patient. For example, thelocation of the crease in the skin between the side of the nose andcheek on the left and right sides of the patient's face may be compared.

A nose assessment module 712 assesses the location of a facial landmarksassociated with the nose and the location of other facial landmarks ofthe patient. For example, the location of the nose centerline may becompared to the forehead centerline or the center of the chin of thepatient.

A mouth assessment module 714 compares the location of facial landmarksassociated with the mouth and the location of other facial landmarks ofthe patient. For example, the location and angle of the left and rightcorners of the mouth of the patient may be compared. In another example,the shape, thickness, and/or length of the lips on the left and rightsides of the center of the mouth may be compared.

A jawline assessment module 716 compares the location of faciallandmarks associated with the jaw on the left and right sides of theface of the patient. For example, the location of the left and rightcorners of the chin of the patient, or angles of the left and rightjawline margins of the patient may be compared.

Any differences between the left and right locations or angularorientations of any facial landmarks described herein above, ascalculated by the comparison/assessment modules 706-716, may indicate anasymmetrical condition of a facial landmark. Referring to FIG. 5, afacial asymmetry display module 534 may display any asymmetries betweenthe left and right facial landmarks to the operator using the display112 (not shown) after the completion of the symmetry analysis of the 2Dfacial image.

ii. 3D Facial Symmetry Assessment Module

Referring back to FIG. 5, the facial asymmetry assessment module 212 mayfurther include a 3D facial symmetry assessment module 504 configured toobtain and analyze a 3D facial image to determine asymmetries betweenselected facial landmarks using modules and methods similar to thecorresponding modules and methods of the 2D facial symmetry assessmentmodule 502. The 3D facial symmetry assessment module 504 includes a 3Dimage acquisition module 524 configured to obtain a 3D facial imageusing a 3D camera, stereoscopic camera, or any other 3D image recordingdevice or scanner operated using a 3D camera interface module 526.

An example of a 3D facial image 900 obtained using the 3D imageacquisition module 524 is illustrated in FIG. 9. In an aspect, the 3Dfacial image 900 may be displayed in the form of a virtual 3Drepresentation that may be rotated about any selected axis to facilitatethe 3D image analysis. In another aspect, the 3D facial image 900 may bedisplayed in the form of a series of 2D representations corresponding todifferent views of the 3D images including, but not limited to front,side, back, perspective, top, and/or bottom views and/or any other 2Drepresentation that may facilitate the 3D facial image analysis.

Referring back to FIG. 5, the 3D image analysis module 528 includes a 3Dguided image analysis module 530 and a 3D automated image analysismodule 532. The 3D guided image analysis module 530 performs a guided 3Dimage analysis on the 3D facial image 900 in which the operator isprompted by a GUI to identify a series of facial landmarks on the 3Dfacial image 900, which are subsequently analyzed to determine numericaldegrees of asymmetry. The 3D image analysis may assess asymmetries ofcorresponding left/right facial landmarks with respect to a plane ofsymmetry. For example, the plane of symmetry may correspond to amidsagittal plane passing through the midline of the nose of thepatient. The facial landmarks analyzed by the 3D guided image analysismodule 530 are similar to those described herein above in connectionwith the facial landmarks analyzed by the 2D guided image analysismodule 520. A similar 3D image analysis may be performed using automatedfacial landmark recognition and analysis methods using the 3D automatedimage analysis module 532.

The degree of asymmetry between corresponding left/right faciallandmarks determined by the 3D facial asymmetry assessment module 504may be quantified using similar methods to those described herein abovein connection with the degree of asymmetry resulting from the 2D imageanalysis. In addition, the 3D degree of asymmetry for each faciallandmark may be displayed using the facial asymmetry display module 534using methods similar to those described herein above for the display ofthe 2D degrees of asymmetry.

FIG. 10 is a flowchart illustrating an embodiment of a facial symmetryassessment module 212A. In this embodiment, the acquisition and analysisof a 2D facial image may be selected at step 1002. The 2D image may beobtained at step 1004 and a guided symmetry assessment of the 2D imagemay be performed at step 1006. Alternatively, or in addition to the 2Dimage analysis, the acquisition and analysis of a 3D facial image may beselected at step 1008. The 3D image may be obtained at step 1010 and anautomated symmetry assessment of the 3D image may be performed at step1012. Facial landmarks having a sufficiently high degree of asymmetrymay be selected for display and further analysis at step 1014. Theoperator may end the facial symmetry analysis at step 1016 and return toa main treatment screen to select additional actions such asadministering a treatment to the facial tissues of the patient.

iii. Trigger Point Analysis Module

Referring back to FIG. 5, the numerical asymmetries determined by thefacial symmetry assessment module 502 may indicate a particulartreatment protocol for one or more facial tissues. The numericalasymmetries may also identify facial landmarks that may be furtheranalyzed using the trigger point analysis module 506. For example, ifthe left corner of a patient's mouth is vertically higher than thecorresponding right corner, this asymmetry may indicate an asymmetry inthe muscle tone, neural activation patterns, and/or vascularizationassociated with the positioning of the corners of the patient's mouth.

The trigger point analysis module 506 may further assess the conditionof the facial tissues of the patient by measuring tissue characteristicsincluding, but not limited to, the galvanic response of a facial tissue,the response of the tissue to an applied force impulse, or any otheraspect of the facial tissue related to, or correlated with, the healthand condition of the facial tissue. The trigger point analysis module506 may use any known instrument to perform an additional assessment ofthe condition of the facial tissues including, but not limited to, afacial stimulator instrument as described herein below, anelectromyographic electrode, or any other known measurement deviceappropriate for measurement of a facial tissue characteristic.

FIG. 11 is a block diagram illustrating an embodiment of a trigger pointanalysis module 506A. The trigger point analysis module 506A includes aninstrument interface module 1102 to provide a GUI or other interfaceused by the operator to conduct measurements using one or more devices,a signal acquisition module 1104 to record a measurement signal obtainedby the one or more devices, a signal analysis module 1106 to process thesignal from the device to determine the condition of the facial tissue,and an instrument control settings module 1108 to provide instrumentcontrol settings such as power settings, frequency of percussiveimpacts, voltage and/or waveform of an applied electrical pulse,frequency of applied acoustic pulses, and any other parameter associatedwith a selected treatment protocol.

The trigger point analysis module 506A may be configured to guide theoperator through the steps of locating a facial landmark, initializingan instrument for measuring a characteristic of a facial tissue in thevicinity of the facial landmark, and obtaining one or more measurementsusing the instrument. The operator may be guided through measurementsfor one or more facial landmarks using the trigger point analysis module506A. The trigger point analysis module 506A may process themeasurements of the characteristics of each facial landmark incombination with that landmark's degree of asymmetry to determine arecommended treatment protocol.

FIG. 12 is a flow chart illustrating an embodiment of a trigger pointanalysis module 506B. In this embodiment, a facial stimulator instrument106, referred to as an Impulse Wave subsystem in FIG. 12, is used tomeasure the reaction of a tissue to an applied force impulse. The facialstimulator instrument 106 is situated at a specified facial landmark atstep 1202. In an aspect, the specified facial landmark may be identifiedas a landmark associated with a relatively high degree of asymmetry bythe facial symmetry assessment module 212. The facial landmark to besubjected to trigger point analysis may be displayed to the operator ofthe system 100 via the display 112. A force impulse is applied to thefacial tissue at step 1204 and a signal encoding the reaction of thefacial tissue to the applied force impulse is acquired by the signalacquisition module 1104 at step 1206. The signal analysis module 1106analyzes the signal at step 1208, and the instrument control settingsare determined by the instrument control settings module 1108 at step1210. The instrument control settings are used by one or more treatmentmodules 216-220 to provide a treatment to a facial tissue of thepatient.

In an aspect, the signal analysis module 1106 may analyze any one ormore characteristics of the facial tissue in response to the forceimpulse applied by the facial treatment instrument 106 including, butnot limited to, the waveform of the facial tissue response. Non-limitingaspects of the waveform of the facial tissue response that may beanalyzed by the signal analysis module 1106 include the peak or maximumamplitude of the waveform, the peak time, the rise time, the fall time,the frequency, and the area under the wave. Peak time, as definedherein, refers to the time from the initiation of the waveform to thepeak amplitude of the waveform. Rise time, as defined herein, refers tothe time elapsed between a waveform amplitude of 10% and 90% of the peakamplitude as the amplitude is rising to the peak amplitude. Fall time,as defined herein, refers to the time elapsed between a waveformamplitude of 90% and 10% of the peak amplitude as the amplitude isfalling from the peak amplitude.

Without being limited to any particular theory, there is complexity inthe differing shapes of the waveforms associated with the response ofthe facial tissues to the force impulses. In an aspect, the signalanalysis module 1106 may generate a mathematical representation of thewaveform of a facial tissue response and may further manipulate andinterpret the mathematical representation so as to define the amount ofresistance, mobility, condition, and/or other characteristics of thefacial tissue.

The signal analysis module 1106 is configured to analyze therelationship of all of the response factors associated with facialtissue treatment and measurement, namely the analysis of the waveformsas they relate to facial tissues in general. The relation to thestiffness characteristic (waveform peak), the hysteresis function (waveshape), and the frequency response provide valuable informationregarding the state of the measured tissue.

In an aspect, the measured waveform may be sinusoidal and may beinfluenced by tissue properties including, but not limited, to tissuemobility or resistance to mobility, fascia tension, muscle tonicity,connective tissue resiliency or inertia, local edema and any combinationthereof. Each such waveform may be characterized mathematically bydetermining the peak amplitude, peak time, rise time, fall time, andslew rate; these quantities may facilitate the calculation of frequencyresponse and certain ratios used to mathematically define the waveformcharacteristics. By analyzing the mathematics of the waveformcharacteristics, the condition of the facial tissues may be assessedusing previously determined relationships of waveform characteristicsand tissue condition.

As the data are collected and logged and after all of the pertinentmathematic calculations are made, a summary display 2500 of the waveformand analysis may be presented on the display 112 as illustrated in FIG.25. The summary display 2500 may include a graphic display of thewaveform 2502, and the pertinent data 2504 and derived ratios 2506 maybe displayed for assessment by the operator during a trigger pointanalysis. The data associated with the summary display 2500 may bestored in the database 122 for use by the facial treatment application120 in determining the appropriate treatment protocol and associatedinstrument control settings. In addition, the stored data associatedwith a trigger point analysis may be incorporated into a morecomprehensive database used to develop and refine predictive diagnosesusing methods of analysis including, but not limited to, clinicalassumptions and statistical models. Normal values associated with thewaveform analysis of healthy facial tissues may be compiled, stored, andused to compare normal versus aberrant facial tissues. Stored data mayalso be used to compare pre-treatment and post-treatment facial tissues.

iv. Facial Asymmetry Display Module

Referring back to FIG. 5, the asymmetries of facial landmarks determinedby the facial symmetry assessment module 212 may be processed fordisplay to the operator using the facial asymmetry display module 534.The asymmetries of the facial landmarks may be expressed in any knownnumerical or graphical format. In one aspect, the asymmetry of eachfacial landmark may be expressed as a numerical degree of asymmetry,defined herein as a numerical difference between a lateral displacementor angular orientation of the left and the corresponding right faciallandmark relative to a reference, such as an axis of symmetry or planeof symmetry described herein above.

The degree of asymmetry may be expressed in terms of the absolutedifference between the left and right distances or angles of thecorresponding facial landmarks. Alternatively, the numerical degree ofasymmetry may be expressed as the difference between the left and rightdistances or angles of the corresponding facial landmarks as apercentage of a reference value such as the average of the left andright distances or angles or the overall maximum or minimum distance orangle. In yet another aspect, the numerical degree of asymmetry may benormalized by dividing each difference between the left and rightdistances or angles of the corresponding facial landmarks by a numericalconstant such as the maximum or minimum difference between thecorresponding left and right distances or angles amongst all faciallandmarks analyzed.

In other aspects, a 2D facial image 600 and a 3D facial image 900 may beanalyzed using the facial symmetry analysis module 502 and the resultsof the 2D and 3D symmetry analysis may be combined. For example, thedegrees of asymmetry for each facial landmark resulting from theanalyses of the 2D and 3D images may be averaged. Alternatively, theminimum or maximum degree of asymmetry may be selected at each faciallandmark for display to the operator, or any other known method ofcombining data from different sources may be used.

The facial image display module 534 may generate a display of theasymmetry of the facial landmarks using any known format including, butnot limited to, a list, a table, or a graph, or other image format.Non-limiting examples of suitable formats in which the asymmetry of thefacial landmarks may be displayed include: a list of facial landmarksand each landmark's numerical degree of asymmetry, a table of faciallandmarks including the numerical degree of asymmetry, a bar graph orother graph summarizing the numerical degree of asymmetry of each faciallandmark, and a 2D facial image superimposed with markers at each faciallandmark in which the degree of asymmetry of each landmark is encoded asa superimposed number, a color and/or a color intensity of thelandmark's marker.

v. Instrument Control Settings Module

Referring to FIG. 5, the facial symmetry assessment module 212 mayfurther include an instrument control settings module 508 configured todetermine the control settings for the instruments to be used toadminister a treatment to the facial tissues of the patient. The controlsettings may be determined based on the degree of asymmetry of eachfacial landmark, as well as any additional characteristics of the facialtissues determined by the trigger point analysis module 506. In anembodiment, the instrument control settings module 508 may determine oneor more control settings for the facial stimulator instrument 106including, but not limited to: preload tissue compression force,magnitude and frequency of a force impulse, as well as power andwaveform of an electrical stimulation to be applied to the facialtissue. In another embodiment, the instrument control settings module508 may determine one or control settings for the acoustic oscillator108 including, but not limited to: magnitude and frequency of anacoustic pulse to be applied to the facial tissue.

vi. Treatment Selection Module

Referring to FIG. 5, the facial symmetry assessment module 212 mayfurther include a treatment selection module 510 configured to selectone or more treatment protocols based on the analysis of the degree ofasymmetry of the facial tissues determined by the 2D facial asymmetryassessment module 502 and/or the 3D facial asymmetry assessment module504, as well as other facial tissue characteristics determined by thetrigger point analysis module 506. The recommended treatment protocolsmay be displayed to the operator as a list of treatment protocol optionsin an aspect. One or more treatment protocols may be selected from thedisplayed list by the operator in order to initiate one or moretreatments to the facial tissues of the patient.

vii. Facial Image Storage Module

Referring back to FIG. 5, the facial symmetry assessment module 212 mayfurther include a facial image storage module 512 configured to storeone or more facial images and associated data in the database 122 (notshown). Non-limiting examples of facial images include 2D facial images600 and 3D facial images 900 obtained before and/or after a treatment ofa facial tissue. Non-limiting examples of data associated with the oneor more facial images to be stored by the a facial image storage module512 include: facial landmarks, degrees of asymmetry of each faciallandmark, other characteristics of the facial tissues measured by thetrigger point analysis module 506, instrument control settings, and ahistory of previous facial tissue treatments using the system 100. Inone aspect, the information stored by the facial image storage module512 may be used to compare the effects of a facial treatment on thedegree of asymmetry or other characteristic of the treated facialtissue. In another aspect, the stored treatment protocol informationassociated with the one or more facial images may be used to specify asubsequent treatment of the facial tissues.

c. Operator-Selected Treatment Module

Referring back to FIG. 2, the treatment protocol selection module 208includes an operator-selected treatment module 214 configured to developand implement a treatment protocol specified by an operator via theinput device 114. In an aspect, the operator-selected treatment module214 may offer guidance to the operator in the form of menus or suggestedranges for applied voltages, stimulation frequencies, force impulsemagnitudes, frequencies of impulse production, and any other parameterassociated with the treatment protocol selected by the operator.

In an aspect, the operator may specify a particular treatment mode andfacial landmarks to be treated. A facial image may be displayed within aGUI display in this aspect to show the selected facial landmarks to betreated. Upon selection of a particular facial landmark, the GUI maydisplay the control settings of the instrument used to provide thetreatment to the facial tissues of the patient to the operator. Theoperator may then specify the control settings of the instrument via theGUI. Alternatively, the GUI may guide the operator through a measurementof another characteristic of the facial tissue, and control settings ofthe instrument may be recommended to the operator based on the measuredcondition of the facial tissue. The instrument control settings are usedto configure the instrument used to administer the treatment to thefacial tissues of the patient.

IV. Treatment Modules

Referring back to FIG. 2, the treatment protocol selection module 120Aselects a treatment protocol for a treatment of a facial tissue of apatient as discussed herein above. To implement the selected treatmentprotocol, the system 100A may make use of one or more treatment modules:a neural treatment module 216, a muscular treatment module 218, and acirculatory treatment module 220. In general, each of the treatmentmodules provides an interface with which the operator may configure theinstrument to be used to treat the facial tissue of the patientaccording to the selected treatment protocol. In addition, each of thetreatment modules may provide step-by-step guidance to the operator forplacing the instrument on one or more selected facial landmarks of thepatient and operating the instrument used to provide the treatmentspecified by the selected treatment protocol.

In an aspect, post-treatment 2D facial images 600 and/or 3D facialimages 900 may be obtained following the completion of the treatment ofthe facial tissues to document any changes to the condition of thefacial tissues resulting from the treatment. In another aspect, othermeasurements of the condition of the facial tissues including, but notlimited to, the response of the facial tissue in reaction to appliedforce impulses or electrical pulses may be obtained. The post-treatmentimages and measurements may be stored in the database 122 in anembodiment.

Detailed descriptions of the neural treatment module 216, the musculartreatment module 218, and the circulatory treatment module 220 areprovided herein below.

a. Neural Treatment Module

In an aspect, the neural treatment module 216 guides the operatorthrough a treatment of a facial nerve tissue in accordance with aselected treatment protocol. In this aspect, the neural treatment module216 may apply percussive impacts to facial nerves using the facialstimulator instrument 106. Other treatment protocols including, but notlimited to, electrical stimulation and/or acoustic oscillations appliedto facial nerve tissues may be implemented in other embodiments.

Without being limited to any particular theory, the treatment protocolsimplemented by the neural treatment module 216 may target Golgi tendonorgans within the facial tissues of the patient. The Golgi tendon organsare encapsulated mechanoreceptors located at the myo-tendinous andmyo-aponeurosis junctions. As muscle fibers shorten during a musclecontraction, the Golgi capsule containing the Golgi tendon organ becomesdistorted and the contraction of the fibers forming the Golgi capsuleexerts a strain on the encapsulated collagen bundle within the Golgicapsule causing a deformation of sensory terminals. The Golgi tendonorgan has a very low activation threshold, and even a single musclefiber twitch may elicit a discharge from this receptor. The dischargefrequency of the Golgi tendon organ controls the proprioceptiveresponse. Under prolonged muscle fiber contractions, such as may occurunder static and prolonged muscle loading, the discharge frequency ofthe Golgi tendon organ diminishes, causing the proprioceptive responseto be minimized or extinguished altogether. As a result of an attenuatedproprioceptive response, agonist/antagonist muscle activity becomesspastic and static. In addition, a prolonged static loading conditionmay result in hyperactivity of the nociceptor response resulting in painand additional muscle spasms.

Golgi tendon organs are known to fire harmonically with stimulatingimpulses up to 80 Hz and in a subharmonic manner (½ to ⅓) above 80 Hz.The Golgi tendon organ (I_(b)) afferents are also known to display aninverse pattern of activity relative to the firing of (I_(a)) afferents.As a result, the motor response may be inversely proportional to Golgitendon organ firing; as the discharge frequency from Golgi tendon organsis depressed, the motor response becomes more active. Therefore thereduction in the frequency of Golgi tendon organ firing under prolongedstatic muscle contraction may induce a motor response hyperactivity akinto muscle hypertonia.

If a Golgi tendon organ is stimulated by applying low magnitude forceoscillations within the known frequency response window of the Golgicapsule, the resulting Golgi tendon organ discharge frequency mayrespond harmonically to the induced oscillation frequency, inducing anappropriate proprioceptive response. In particular, the applied forceoscillations may elicit a harmonic response of the Ib afferents of theGolgi tendon organ, resulting in diminished nociceptor signaling and thealleviation of pain, absent other factors such as chemical irritants,infection or inflammation within the afflicted facial tissue.

FIG. 13 is a block diagram illustrating an embodiment of a neuraltreatment module 216A. The neural treatment module 216A may include afacial nerve image display module 1302 to produce a GUI used to guidethe operator through a treatment of a facial nerve tissue. An instrumentconfiguration module 1304 may be used to specify the control settings ofthe facial stimulator instrument used to implement a treatment of thefacial nerve tissue including, but not limited to the magnitude andfrequency of the applied percussive force, and the duration of thetreatment. A trigger point frequency analysis module 1306 may guide theoperator through an analysis in which the facial stimulator instrumentis used to measure the response of the facial tissue through a range offrequencies of the applied percussive force and determine one or moreinstrument control settings based on an analysis of the measured tissueresponse. The instrument interface module 1308 provides a GUI or otherinterface used by the operator to operate the facial stimulatorinstrument while implementing a selected treatment protocol.

An example of a facial nerve display 1400 is illustrated in FIG. 14. Thefacial nerve display 1400 may include a nerve image 1402 illustratingthe location of facial nerves to aid the operator in locating theappropriate region for treatment. In an aspect, the location of faciallandmarks 1404A-1404F identified by the treatment protocol selectionmodule 208 may be superimposed on the nerve image 1402. The frequency atwhich the force impulses are applied to the facial nerve tissues may bedisplayed and/or specified using a GUI control element such as theslider control 1408 illustrated in FIG. 14.

The facial nerve display 1400 may further include buttons 1406A-1406Nused to control various other aspects of the treatment of the facialnerve tissue. The number of force impulses applied at each faciallandmark may be specified by selecting one of buttons 1406F-14061. Themagnitude of the force impulses may be specified by selecting one ofbuttons 1406J-1406M. A trigger point analysis may be initiated byselecting button 1406E. Useful reference information may be accessed bythe operator by selecting button 1406C. The operator may move betweenfacial landmarks to be treated by selecting button 1406B, restart thetreatment by selecting 1406A, or cease treatment of the facial nervetissues by selecting button 1406N.

FIG. 15 is a flow chart illustrating an embodiment of the neuraltreatment module 216B. The nerve image 1402 and controls for the facialstimulator instrument 106 may be displayed in the facial nerve display1400 at steps 1502 and 1504. The neural treatment module 216B determineswhether instrument control settings have been specified using the storedtreatment protocol module 210 or facial symmetry assessment module 212at step 1506. If no instrument control setting has been specified, theinstrument control settings are populated with default values at step1508. Once the default values have been loaded, the neural treatmentmodule 216B determines if a trigger point analysis is desired to refinethe default settings at step 1510. If desired, a trigger point analysisis performed at the facial landmark at step 1512.

If instrument control settings were identified at step 1506, thesettings are loaded into the facial nerve display 1400 at step 1514. Afacial landmark to be treated is displayed on the facial nerve display1400 at step 1516. If a trigger point analysis was conducted, therecommended instrument control settings are loaded in to the facialnerve display 1400 at step 1518, and the treatment is implemented atstep 1520.

b. Muscular Treatment Module

Referring back to FIG. 2, the muscular treatment module 218 isconfigured to guide the operator through a treatment of one or morefacial muscles associated with one or more facial landmarks inaccordance with a selected treatment protocol. In this aspect, themuscular treatment module 218 may apply percussive impacts and/orelectrical stimulation to facial muscles using the facial stimulatorinstrument 106. Other treatment protocols including, but not limited to,acoustic oscillations applied to facial muscles may be implemented inother embodiments. The acoustic (Audio) oscillations may be in the formof pulse modulated RF and/or Amplitude modulated RF in variousembodiments including square or sine waves.

The treatment protocols implemented by the muscular treatment module 218may promote the health of facial muscles by reducing fluid stasis,thereby relieving muscle inflammation resulting from an altered chemicalenvironment of the tissues and improving tissue metabolism in an aspect.In other aspects, the muscular treatment module 218 may implement atendon vibration treatment that may stimulate mechanoreceptors, inducingthe relaxation of muscles.

The relaxation of facial muscles induced by the treatment protocolsimplemented by the muscular treatment module 218 may reduce theappearance of facial wrinkles associated with the prolonged contractionof one or more facial muscles. Non-limiting examples of types of facialwrinkles that may be reduced in appearance after treatments of thefacial muscles include: horizontal forehead lines associated withcontraction of the frontalis muscle; glabellar frown lines associatedwith the contraction of corrugator and procerus muscles; crow's feetassociated with movement of the orbicularis oculi; perioral linesassociated with the contraction of the orbicularis oris sphincter of themouth; marionette folds associated with contraction of the depressoranguli oris muscle; platysma bands associated with contraction of theplatysma muscles; and any combination thereof.

FIG. 16 is a block diagram illustrating an embodiment of a musculartreatment module 218A. The muscular treatment module 218A may include afacial muscle image display module 1602 to produce a GUI used to guidethe operator through a treatment of a facial nerve tissue. An instrumentconfiguration module 1604 may be used to specify the control settings ofthe facial stimulator instrument 106 used to implement a treatment ofthe facial muscle tissue including, but not limited to the magnitude andfrequency of the applied force impulse, and the duration of thetreatment. A trigger point frequency analysis module 1606 may guide theoperator through an analysis in which the facial stimulator instrumentis used to measure the response of the facial tissue through a range offrequencies of the applied force impulse and to determine one or moreinstrument control settings based on an analysis of the measured tissueresponse. The instrument interface module 1608 provides a GUI or otherinterface used by the operator to operate the facial stimulatorinstrument while implementing a selected treatment protocol.

An example of a facial muscle display 1700 is illustrated in FIG. 17.The facial muscle display 1700 may include a muscle image 1702illustrating the location of facial muscle to aid the operator inlocating the appropriate region for treatment. In an aspect, thelocation of facial landmarks 1704A-1704E identified by the treatmentprotocol selection module 208 may be superimposed on the muscle image1702. The frequency at which the force impulses are applied to thefacial muscle tissues may be displayed and/or specified using a GUIcontrol element such as the slider control 1708 illustrated in FIG. 17.

The facial muscle display 1700 may further include buttons 1706A-1706Nused to control various other aspects of the treatment of the facialmuscle tissue. The number of force impulses applied at each faciallandmark may be specified by selecting one of buttons 1706F-17061. Themagnitude of the force impulses may be specified by selecting one ofbuttons 1706J-1706M. A trigger point analysis may be initiated byselecting button 1706E. Useful reference information may be accessed bythe operator by selecting button 1706C. The operator may move betweenfacial landmarks to be treated by selecting button 1706B, restart thetreatment by selecting 1706A, or cease treatment of the facial muscletissues by selecting button 1706N.

FIG. 18 is a flow chart illustrating an embodiment of the musculartreatment module 218B. The muscle image 1702 and controls for the facialstimulator instrument 106 may be displayed in the facial muscle display1700 at steps 1802 and 1804. The muscular treatment module 216Bdetermines whether instrument control settings have been specified usingthe stored treatment protocol module 210 or facial symmetry assessmentmodule 212 at step 1806. If no instrument control setting has beenspecified, the instrument control settings are populated with defaultvalues at step 1808. Once the default values have been loaded, themuscular treatment module 218B determines if a trigger point analysis isdesired to refine the default settings at step 1810. If desired, atrigger point analysis is performed at the facial landmark at step 1812.

If instrument control settings were identified at step 1806, thesettings are loaded into the facial muscle display 1700 at step 1814. Afacial landmark to be treated is displayed on the facial muscle display1700 at step 1816. If a trigger point analysis was conducted, therecommended instrument control settings are loaded into the facialmuscle display 1700 at step 1818, and the treatment is implemented atstep 1820.

c. Circulatory Treatment Module

Referring back to FIG. 2, the circulatory treatment module 220 isconfigured to guide the operator through a treatment of one or morefacial circulatory vessels associated with one or more facial landmarksin accordance with a selected treatment protocol. In this aspect, thecirculatory treatment module 220 may apply acoustic pulses to facialcirculatory vessels using the acoustic oscillator 108. Other treatmentprotocols including, but not limited to, force impulses and/orelectrical stimulation applied to facial circulatory vessels may beimplemented in other embodiments.

The treatment protocols implemented by the circulatory treatment module220 may stimulate enhanced blood flow to the facial tissues, therebyenhancing the health and appearance of facial tissues.

FIG. 19 is a block diagram illustrating an embodiment of a circulatorytreatment module 220A. The circulatory treatment module 220 may includea facial circulatory vessel image display module 1902 to produce a GUIused to guide the operator through a treatment of a facial circulatoryvessel. An instrument configuration module 1904 may be used to specifythe control settings of the acoustic oscillator used to implement atreatment of the facial circulatory vessel tissue including, but notlimited to the magnitude and frequency of the applied acoustic pulses,and the duration of the treatment. The instrument interface module 1908provides a GUI or other interface used by the operator to operate theacoustic oscillator while implementing a selected treatment protocol.

A trigger point frequency analysis module 1906 may guide the operatorthrough an analysis in which the facial stimulator instrument 106 isused to measure the response of the facial tissue through a range offrequencies of applied percussive force at the various facial landmarksselected for treatment and to determine one or more instrument controlsettings based on an analysis of the measured tissue response. Forexample, the trigger point frequency analysis module 1906 may determinea resonant frequency for each of the facial landmarks using the tissueresponse measured by the facial stimulator instrument 106. Theseresonant frequencies may be used as a basis for a treatment frequencyprotocol at each of the facial landmarks that specifies the frequency ofacoustic pulses to be applied at each facial landmark.

In an aspect, the treatment frequency protocol may be a sweepconcentration frequency protocol, in which the acoustic pulses areprovided in the form of a programmable duty cycle transmission wave. Inthis aspect, the acoustic pulses may have an oscillation frequencyranging between about 800 KHz and about 1 MHz delivered at a pulse rateranging between about 3 Hz and about 300 Hz. In this aspect, the pulserate may be concentrated within the harmonics and sub-harmonics of theresonant frequency determined by the trigger point frequency analysismodule 1906. This pulse can be delivered as a burst or in an amplitudemodulated form.

In another aspect, the treatment frequency protocol may be a harmonicsweep concentration protocol similar to the sweep concentrationfrequency protocol, except that the pulse rate may be initially set atthe exact resonant frequency determined by the trigger point frequencyanalysis module 1906 and subsequently swept up and down the harmonicrange.

In an additional aspect, the treatment frequency protocol may be aresonance concentration similar to the sweep concentration frequencyprotocol and harmonic sweep protocol, except that the pulse rate isinitialized and maintained at the specific resonant frequency determinedby the trigger point frequency analysis module 1906.

An example of a circulatory vessel display 2000 is illustrated in FIG.20. The circulatory vessel display 2000 may include a circulatory vesselimage 2002 illustrating the location of a circulatory vessel muscle toaid the operator in locating the appropriate region for treatment. In anaspect, the location of facial landmarks 2004A-2004G identified by thetreatment protocol selection module 208 may be superimposed on thecirculatory vessel image 2002. The frequency at which the acousticpulses are applied to the facial circulatory tissues may be displayedand/or specified using a GUI control element such as the slider control2008 illustrated in FIG. 20.

The facial circulatory vessel display 2000 may further include buttons2006A-2006N used to control various other aspects of the treatment ofthe facial circulatory tissue. The duration of the acoustic pulsesapplied at each facial landmark may be specified by selecting one ofbuttons 2006F-2006I. The magnitude of the acoustic pulses may bespecified by selecting one of buttons 2006J-2006M. A trigger pointanalysis may be initiated by selecting button 2006E. Useful referenceinformation may be accessed by the operator by selecting button 2006C.The operator may move between facial landmarks to be treated byselecting button 2006B, restart the treatment by selecting 2006A, orcease treatment of the facial circulatory vessels by selecting button2006N.

FIG. 21 is a flow chart illustrating an embodiment of the circulatorytreatment module 220B. The circulatory vessel image 2002 and controlsfor the acoustic oscillator 108 may be displayed in the circulatoryvessel display 2000 at steps 2102 and 2104. The circulatory treatmentmodule 220B determines whether instrument control settings have beenspecified using the stored treatment protocol module 210 or facialsymmetry assessment module 212 at step 2106. If no instrument controlsettings have been specified, the instrument control settings arepopulated with default values at step 2108. Once the default instrumentcontrols settings have been loaded, the circulatory treatment module220B determines if a trigger point analysis is desired to refine thedefault settings at step 2110. If desired, a trigger point analysis isperformed at the facial landmark at step 2112.

If any instrument control settings were identified at step 2106, thesettings are loaded into the circulatory vessel display 2000 at step2114. A facial landmark to be treated is displayed on the facialcirculatory vessel display 2000 at step 2116. If a trigger pointanalysis was conducted, the recommended instrument control settings areloaded into the facial circulatory vessel display 2000 at step 2118, andthe treatment is implemented at step 2120.

V. Database

Referring back to FIG. 1, a database 122 may store a variety of data foruse by the facial treatment system 100 to provide a treatment to thefacial tissues of a patient. In an aspect, the database 122 may includethe entries associated with stored treatment protocols 124, storedpatient data 126, and measurement-correlated instrument control settings132. In an aspect, the stored patient data 126 may include stored facialimages 128 and patient-specific treatment protocols 130. The entriesstored in the database 122 may be accessed by the modules of the facialtreatment application 120 to aid in the analysis of the condition of apatient's facial tissues, the selection of a treatment protocol, and thespecification of one or more instrument control settings associated witha selected treatment protocol and/or a measured characteristic of afacial tissue, and the implementation of the facial tissue treatment bythe system 100.

a. Stored Treatment Protocols

In an aspect, the stored treatment protocols 124 may provide theinstrument control settings, facial landmarks, and/or any otherinformation specifying a treatment protocol. FIG. 23 is a diagrammaticdepiction of an embodiment of a stored treatment protocol 124A. In thisaspect, the stored treatment protocol database 124A includes a list ofaffliction diagnosis entries 2302 and associated treatment protocols2304. The affliction diagnosis entries 2302 may be any of theafflictions of the facial tissues described previously herein above.Non-limiting examples of affliction diagnosis entries 2302 includechanges in appearance related to aging and erosion of subdermal fat,thinning of the skin, loss of elasticity and tone of skin, formation ofwrinkles or jowls, changes or irregularities in skin coloration, and anyof the disorders of the facial tissues including facial muscle spasms,decreased movement control, chronic migraines, facial neuralgia, facialparalysis, facial nerve injuries, and facial tissue abnormalitiesassociated with systemic disorders such as muscular dystrophy.

b. Stored Patient Data

In another aspect, the database 122 may further include stored patientdata 126 including, but limited to, information about the patient suchas age, height, weight, and medical history, results of analyses of thepatient's facial tissues, treatments performed on the patient's facialtissues, notes and comments by the operator, and a schedule of futuretreatments to be performed. The information contained within the storedpatient data 126 provides information for use by the operator of thesystem 100 to select a treatment, assess the efficacy of an administeredtreatment, and/or select a future treatment protocol. The history ofpatient analysis and treatment may be compiled and used for discussionof patient's condition and progress as well as justification forcontinuing treatment and rehabilitation.

i. Stored Facial Images

In an additional aspect, facial images of the patient obtained before,during, and/or after a treatment may be stored in the stored facialimages 128. The facial images may be 2D facial images and/or 3D facialimages described herein above. The facial images may be stored for oneor more treatments and may be used to assess the efficacy of thetreatments over an extended time period. In another aspect, additionalinformation such as facial landmarks, analysis results, calculatedasymmetry data, and previously suggested treatments may be associatedwith the facial images and stored in the stored facial images 128.

ii. Patient-Specific Treatment Protocols

In another additional aspect, a set of treatment protocols customizedfor a particular patient may be stored in the stored patient data 126 aspatient-specific treatment protocols 130. The entries within thepatient-specific treatment protocols may include information including,but not limited to facial landmarks to be treated, the type of treatmentto be applied, the instrument control settings associated with thetreatment protocol, and any other information useful to defining aparticular treatment protocol and implementing the treatment. In anaspect, the patient-specific treatment protocols 130 may be accessed bythe operator and used to implement the treatment of a patient's facialtissues without need for a facial tissue symmetry assessment or othermeasurements of the condition of the patient's facial tissues. Inanother aspect, the patient-specific treatment protocols 130 may includethe treatment protocols of treatments to be administered according to aschedule developed by the operator.

iii. Stored Instrument Control Settings

In another additional aspect, one or more tables containing entries usedto determine one or more instrument control settings based on one ormore measurements of the condition of a facial tissue may be stored inthe measurement-correlated instrument control settings 132. Theseentries may be accessed by modules of the facial treatment applicationrelated to trigger point analysis, dynamic adjustment of controlsettings, implementation of treatment protocols, and the like. Anyinstrument control setting of any instrument described herein may bestored as a function of any measurement of the facial tissue in themeasurement-correlated instrument control settings 132.

An example of a table 132A is illustrated in FIG. 27. In this table132A, the instrument control settings 2702 associated with an electricalstimulation are stored as a function of the measured frequency response2704 of a facial tissue in response to a force impulse applied by thefacial stimulator instrument 106. In addition, the instrument controlsettings 2702 may be stored as a function of another measured facialtissue characteristic 2706.

Another example of a table 132B is illustrated in FIG. 28. In this table132B, the instrument control settings 2802 associated with an electricalstimulation are stored as a function of the measured change in galvanicresponse 2804 of a facial tissue in response to an electrical pulseapplied by the facial stimulator instrument 106. In addition, theinstrument control settings 2802 may be stored as a function of anothermeasured facial tissue characteristic 2806.

VI. Cameras

Referring back to FIG. 1, the facial treatment system 100 may includeone or more cameras to obtain facial images of the patient to beanalyzed for symmetry of facial landmarks. These images may be takenbefore, during, and/or following a treatment of the facial tissues of apatient using the facial treatment system 100. The analysis of thefacial images may be used to determine a recommended treatment protocol,to assess the effect of a treatment of the facial tissues by comparing apre-treatment analysis to a post-treatment analysis, and/or to monitorthe condition of the facial tissues by comparing two or more analysesover a period of time.

Any device capable of obtaining a digital image that is compatible withthe computing device 102, and in particular with the facial treatmentapplication 120 may be included in the system 100. In an aspect, the oneor more cameras 104 are capable of being operated remotely using modulesof the facial treatment application 114. Any known device capable ofrecording a facial image in digital format may be included in the system100 including, but not limited to 2D cameras, 3D stereoscopic cameras,and 3D scanning devices. Non-limiting examples of 3D scanning devicesinclude time-of-flight 3D laser scanners, triangulation 3D laserscanners, LIDAR scanners, structured-light 3D scanners, modulated light3D scanners, CT scanners, MRI scanners and any other known 3D scanningdevice. In another aspect, other devices may be used to obtainadditional types of facial images including, but not limited to,infrared imaging devices and ultrasound scanners.

VII. Facial Stimulator Instrument

Referring again to FIG. 1, the facial tissue treatments of a patient maybe implemented using one or more instruments, including a facialstimulator instrument 106. The facial stimulator instrument 106 may beconfigured to deliver a mechanical force impulse and/or an electricalstimulation to the facial tissues. In addition, the facial stimulatorinstrument 106 may be configured for the measurement of facial tissueresponse arising from the application of a force impulse and/orelectrical pulse to the facial tissue of a patient.

FIG. 22 is a side view of the facial stimulator instrument 106 in oneaspect. The facial stimulator instrument 106 includes an impulse andsensing head 2202 that contacts the facial tissues of the patient todeliver the mechanical force impulses and/or electrical pulses. Theimpulse and sensing head 2202 includes a probe 2204 with one or moretips 2216 that contact the facial tissues of the patient. Apiezoelectric sensor 2206 is firmly attached to the probe 2204, and ananvil 2208 is firmly attached to the piezoelectric sensor 2206. Asolenoid assembly 2220 containing an armature 2212 inserted withoutattachment into an electromagnetic coil 2210 is also included in theimpulse and sensing head 2202. A pressure sensor 2214 may be attached tothe head 2202 and configured so that when the probe 2204 is pressedagainst the patient's facial tissue and reaches a predeterminedpressure, the pressure sensor 2214 causes a release of a burst ofcurrent to energize the electromagnetic coil 2210. When theelectromagnetic coil 2210 is energized, the armature 2212 is acceleratedto impact the anvil 2208 and thereby produce a force impulse, whichtravels through the piezoelectric sensor 2206 and probe 2204, therebytransmitting the force impulse to the facial tissues of the patient incontact with the probe 2204.

As illustrated in FIGS. 24A-24D, a variety of different configurationsof probes 2204 may be employed with the impulse and sensing head 2202.For example, as illustrated in FIG. 25A, the dual-tipped probe 2204A mayhave a generally horseshoe shape ending in two laterally separated tips2216B and 2216C; the tips 2216B and 2216C may be constructed of a softmaterial. The tips 2216B and 2216C may attach to a stem 2402A. The endof the stem 2402A opposite to the tips 2216B and 2216C may be coupled tothe piezoelectric sensor 2206 (not shown) during use. Each of the tips2216B and 2216C may end in attached electrodes 2218C and 2218D. The tips2216B and 2216C of the dual-tipped probe 2204A may extend generally aneven distance from the body 2402A. As shown in FIG. 24B, an alternativeembodiment of a dual-tipped probe 2204B may have tips 2216D and 2216Ethat do not extend an even distance away from the body 2402B.

In another embodiment, illustrated in FIG. 24C, a single-tipped probe2204C may include a single tip 2216F extending from the body 2402C andending in a single electrode 2218E. In this embodiment, a secondelectrode patch or other conductor may be attached to the skin of thepatient in the vicinity of the facial landmark to which thesingle-tipped probe 2204C is pressed in order to administer anelectrical stimulation. In an additional embodiment, a single-tippedprobe 2204D may include a single tip 2216G to which a pair of electrodes2218F and 2218G are attached opposite to the attachment of the tip 2216Gto the body 2402D. In this embodiment, electrical stimulation may beadministered by the single-tipped probe 2204D without need foradditional electrode patches or other conductors.

In general, the specific shapes and dimensions of the probe 2204 mayvary amongst the embodiments. In an aspect, the tips 2216B and 2216C ofthe dual-tipped probe 2204A may extend away from the body 2402A to agreater or lesser extent than shown in FIG. 24A, or may be laterallyseparated a greater or lesser distance than that shown on FIG. 24A. Inanother aspect, the difference in tip lengths 2216D and 2216E may begreater or lesser than that shown in FIG. 24B. In an additional aspect,the length, width, and cross-sectional shape of the tip 2216F of thesingle-tipped probe 2204C, as well as the location of the electrode 2218may vary from the embodiment illustrated in FIG. 24C. In yet otheraspects, the shape of the ends of the tips 2218 may generally varyamongst at least several shapes including a flat ended tip asillustrated in FIGS. 24C and 24D, a rounded or hemispherical tip asillustrated in FIGS. 24A and 24B, and any other known tip shape.

Referring back to FIG. 22, the impulse and sensing head 2202 may furtherinclude an elongated and generally cylindrical housing 2228 which has aninsert 2230 that tapers to form a generally conical configuration at theforward end 2232. The other end of the housing 2228 is provided with acylindrical closed end 2234. The housing 2228 and the closed end 2234may be separately connected by a screw threaded connection to provideaccess into the interior of the housing 2228 and to separate thecomponents of the facial stimulator instrument 106 for repair,replacement and the like. After the housing 2228 is unscrewed fromclosed end 2234, it may slide back and insert 2230 may also be unscrewedfrom the housing 2228.

The probe 2204 may further include one or more electrodes 2218A and2218B attached to the one or more tips 2216 such that the electrodes2218A and 2218B contact the skin of the patient in order to deliver anelectrical stimulation to the facial tissues. An electrical stimulationunit 2222 may employ a high frequency oscillator 2224 and a poweramplifier 2226 to generate a series of high frequency electrical pulsesthat are then delivered to the facial tissues of the patient via theelectrodes 2218A and 2218B contacting the patient's skin.

The design of the facial stimulator instrument 106 also provides theability to monitor the force impulses and electrical stimulation as theyare applied to the facial tissues. The piezoelectric sensor 2206 maymonitor the force impulses as they are applied to assess the response ofthe facial tissue of the patient to the application of the forceimpulses; the signals produced by the piezoelectric sensor 2206 may beoutput to the computing device 102 for processing by the facialtreatment application 120. The pressure sensor 2214 may output datacharacteristic of the pressure of the probe 2204 in contact with thefacial tissue of the patient to the computing device 102 for processingby the facial treatment application 120.

The facial stimulator instrument 106 may obtain power from the computingdevice 102 via an electrical cable 2236. Alternatively, electrical powermay be supplied through an additional electrical cord (not shown) thatmay be electrically connected to an external power supply, suitableelectrical outlet, or the like, which extends into the housing 2228.

In an aspect, the facial stimulator instrument 106 receives signals fromthe computing device 102 that control the production and delivery offorce impulses and/or electrical stimulation in accordance with atreatment protocol selected and specified using the modules of thefacial treatment application 120 as described herein previously. A moredetailed description of the design of the facial stimulator instrument106 in relation to the delivery of force impulses and electricalstimulation is provided herein below.

a. Force Impulse Production

In an aspect, the facial stimulator instrument 106 is configured todevelop and deliver a series of force impulses to the facial tissues ofa patient, resulting in a percussive massage therapy. The probe 2204 ofthe facial stimulator instrument 106 may oscillate by repetitivelyaccelerating the armature 2212 to impact the anvil 2208 at a controlledfrequency and a predetermined time period. Control signals received fromthe computing device 102 by the facial stimulator instrument 106 via anelectrical cable 2236 or other signal communication method control oneor more characteristics of the force impulses. Non-limiting examples ofcharacteristics of the force impulses include the frequency ofproduction of the force impulses, the peak force of each force impulses,the duration of the series of force impulses.

In another aspect, the frequency of production of the force impulses mayrange between about 0.1 Hz and approximately 12 Hz. In an additionalaspect, the frequency of production of the force impulses may be variedaccording to a predefined schedule received from the facial treatmentapplication 120. For example, the frequency of production of the forceimpulses may gradually increase from about 4 Hz to about 12 Hz inincrements of about 0.1 Hz. In yet another aspect, the frequency ofproduction of the force impulses may be continuously varied based on theanalysis of measurements of facial tissue response to the force impulsesperformed by the facial treatment application.

In another aspect, the force impulses may be delivered by the facialstimulator instrument 106 in coordination with the delivery of theelectrical stimulation. For example, an electrical stimulus such as anelectrical pulse may be generated and delivered via electrodes 2218A and2218B to the patient at the same instant that the armature 2212 isaccelerated to generate a force impulse. The coordination of thedelivery of force impulses and electrical stimulation may be controlledusing signals received by the facial stimulator instrument 106 from thefacial treatment application 120.

The force impulses are delivered to the facial tissues via the tips 2216of the probe 2204 located at the forward end 2232 of the housing 2228.In an aspect, the tips 2216 may be cushioned for contacting the softtissue to be treated. The probe 2204 may be constructed of a rigidmaterial such as metal, plastic, or the like. The probe 2204 may screwinto or frictionally insert into the piezoelectric sensor 2206.Different shaped probes 2204 may be used depending on the desiredfunction of the facial stimulator instrument 106. For example, if thefacial stimulator instrument 106 is measuring facial tissue response toforce impulses, a different probe shape may be used compared to a probe2204 used to implement a facial tissue treatment. Electrodes 2218A and2218B may be supported on the probe tips 2216 in order to providesufficient electrical contact with the skin 4 when the probe 2204 isapplied to the patient.

The housing 2228 contains a solenoid assembly 2220. The assembly 2220includes an electromagnetic coil 2210 and an armature 2212longitudinally reciprocally mounted without attachment within the coil2210. The armature 2212 is configured so that the end of the armature2212 will impact against the anvil 2208 when the electromagnetic coil2210 is energized. The anvil 2212 is affixed to one side of apiezoelectric sensor 2206. The impact produces a force impulse whichtravels through the piezoelectric sensor 2206 and causes thepiezoelectric sensor 2206 to generate a waveform.

When any one of the various probes 2204 is placed against the facialtissue of a patient, the end of the probe 2204 opposite to the patientresides firmly against the piezoelectric sensor 2206 which in turnresides firmly against the anvil 2208. In an aspect, a pressure sensor2214 situated within the housing 2228 and interposed between the closedend 2234 of the housing 2228 and the solenoid assembly 2220 may controlthe initiation of a force impulse. The pressure sensor 2214 works inconcert with each of the other components so that upon reachingexceeding a predetermined threshold pressure against the facial tissueof the patient, the pressure sensor 2214 signals the release of a burstof current that energizes the electromagnetic coil 2210, inducing theacceleration of the armature 2212 within the electromagnetic coil 2210until the armature 2212 impacts the anvil 2208.

The impact of the armature 2212 against the anvil 2208 produces a forceimpulse which travels through the piezoelectric sensor 2206 in adirection essentially aligned with the movement of the armature 2212just prior to impact. In an aspect, the direction of travel of the forceimpulse may be influenced by the resistive force of the probe 2204applied to the piezoelectric sensor 2206 opposite to the anvil 2208. Theresistive force results from the contact force of the probe 2204 and thepatient's skin.

The kinetic energy at the point of impact of the armature 2212 on theanvil 2208 causes the piezoelectric sensor 2206 to emit an electronicwaveform which is characteristic of all of the force-producing Vectorsof the electromechanical system situated on the anvil side of thepiezoelectric sensor 2206 and opposed by the patient's facial tissuessituated on the probe side of the piezoelectric sensor 2206. Thiselectronic waveform may be received and processed by modules of thefacial treatment application 120 and may further be stored within thedatabase 122.

The mass of the armature 2212 may be substantially equal to the mass ofthe anvil 2208 so that when the armature 2212 strikes the anvil 2208,the reactive force induced by impact of the armature 2212 is transferredto the facial tissue of the patient through the anvil 2208,piezoelectric sensor 2206, and attached probe 2204. The initialseparation distance of the armature 2212 and anvil 2208 may be fixed bydesign, such that the kinetic energy and resulting impact force may bevaried only by varying the velocity of the armature 2212 at the point ofimpact with the anvil 2208. The velocity of the armature 2212 may bevaried by varying the inductive force of the electromagnetic coil 2210on the armature 2212 by varying the magnetization time (excitationstime) to the electromagnetic coil with constant voltage and current.2210.

In one aspect, the solenoid assembly 2220 may be actuated by processingmeasurements from a pressure sensor 2214 and actuating the solenoidassembly 2220 when the measured pressure meets or exceeds a thresholdpressure as described herein above. The pressure sensor 2214 may be anyknown pressure-sensing device including, but not limited to, a loadcell.

In another aspect, the trigger point at which the solenoid assembly 2220may be actuated by the movement of the housing 2228 relative to thesolenoid assembly 2220 produced by pressing the probe tip 2216 againstthe skin of the patient. This movement may be configured to complete anelectrical circuit to the power supply of the solenoid assembly 2220when a preset probe tip pressure is matched or exceeded. In an aspect,the preset pressure may be varied by varying the resistance of therelative movement of the housing 2228 to the probe tip pressure byincorporating a resilient element such as a spring between the structureof the housing 2228 and the support structure of the solenoid assembly2220. In another aspect, the present pressure may be varied by varyingthe distance of relative movement needed to complete the electricalcircuit to the power supply of the solenoid assembly 2220.

b. Electrical Stimulator Function

In an aspect, the facial stimulator instrument 106 is configured todevelop and deliver electrical stimulation comprising a series ofelectrical pulses to the facial tissues of a patient through the probetip-mounted electrodes 2218A and 2218B, providing an electrostimulationtherapy to the facial tissues. Control signals received from thecomputing device 102 by the facial stimulator instrument 106 via anelectrical cable 2236 or other signal communication method control oneor more characteristics of the electrical stimulation. Non-limitingexamples of characteristics of the electrical stimulation include thefrequency of production of the electrical pulses, waveforms of theelectrical pulses, the current or voltage of the electrical pulses, andthe duration of the series of electrical pulses.

The electrical stimulation falls within known ranges typically used forthis type of therapy. For example, the frequency of production of theelectrical pulses may be varied between about 0.1 Hz and about 150 Hz.Non-limiting examples of suitable waveforms for electrical pulses usedin the electrical stimulation include high voltage mono-phasic, highvoltage bi-phasic, Russian symmetrical bi-phasic, square wavemono-phasic, square wave bi-phasic, and any combination thereof. Inanother aspect, the galvanic response of the facial tissue being treatedmay be monitored via the electrodes 2218A and 2218B and processed bymodules of the facial treatment application 120 to calculate any changein the galvanic response of the facial tissue resulting from thetreatment. The calculated change in galvanic response of the facialtissue being treated may be used to determine if, and how, theelectrical stimulation of the treatment may be changed. The galvanicresponse may be monitored continuously during the treatment, measuredover a discrete pre-treatment period, and/or measured over a discretepost-treatment period.

The electrical stimulation administered to the facial tissues by thefacial stimulator instrument 106 is produced using a high frequencyoscillator 2224 and a power amplifier 2226 electrically connected to theelectrodes 2218A and 2218B. When pressed against the skin of thepatient, the electrical current is transferred from the electrode 2218to the patient's facial tissues. In one embodiment, the delivery of theelectrical stimulation is synchronized with the delivery of the forceimpulses by one or more modules of the facial treatment application 120.The peak amplitude of the electrical stimulation may be limited by thepatient's comfort level during treatment. The lower the peak amplitudeof the electrical pulses, the more tolerant the patient is to theelectrical stimulation transmitted by the electrode 2218.

In one aspect, the application of electrical stimulation to a facialtissue involves pressing a pair of electrodes 2218A and 2218B attachedto the probe tips 2216 against the skin of the patient, and causing apulse of electrical current to flow from one electrode 2218A, through afacial tissue, and back to the other electrode 2218B. In another aspect,the application of electrical stimulation involves pressing a singleelectrode 2218 to the skin of a patient and causing a pulse ofelectrical current to flow from the electrode 2218 to an electrode patchor other electrical conductor also attached to the skin of the patient.In this aspect, the electrode patch or other electrical conductor may beadhered or otherwise attached to the skin of the patient in a locationnear the facial landmark at which the electrode is pressed.

VIII. Acoustic Oscillator (RF Generator Modulated by Acoustic (Audio)Modulator)

Referring again to FIG. 1, the facial tissue treatments of a patient 110may be implemented using an acoustic oscillator 108. The acousticoscillator 108 may be configured to deliver a series of acoustic pulsesto the facial tissues of a patient. The operation of the acousticoscillator is typically controlled by a GUI or other graphic displaygenerated by the facial treatment application 120.

An embodiment of an acoustic oscillator 108A is illustrated in FIG. 26.The acoustic coupler may include a transducer 2602 electricallyconnected to a band-pass filter and coupler 2604. An electricaloscillator 2608 and amplifier 2606 may supply the oscillating electricalsignal used to drive the transducer 2602 at the desired frequency andamplitude. An electrical cable 2612 electrically connected to thecomputing device 102 supplies power to the acoustic oscillator. Inaddition, the electrical cable 2612 carries signals encoding databetween the acoustic oscillator and the facial treatment application 120resident on the computing device 102. A housing 2610 may contain theband-pass filter and coupler 2604, the electrical oscillator 2608 andthe amplifier 2606. In addition, the transducer 2602 may be mounted toone end of the housing 2610,

In an aspect, the acoustic oscillator 108 receives signals from thecomputing device 102 that control the production and delivery ofacoustic pulses in accordance with a treatment protocol selected andspecified using the modules of the facial treatment application 120 asdescribed herein previously. The acoustic oscillator 120 may receiveinstrument control settings generated by the facial treatmentapplication 120A including, but not limited to, the acoustic wave type,acoustic wave frequency, and acoustic wave amplitude within an acousticpulse, the frequency of production of acoustic pulses, the duration ofthe series of acoustic pulses, and any other relevant instrument controlsettings.

In one aspect, the acoustic oscillator 108 may generate RF pulses havinga frequency ranging between about 500 kHz and about 1.5 MHz. In anotheraspect, the acoustic oscillator 108 may generate acoustic pulses havinga frequency of about 800 kHz. The form of the generated RF pulse may beany known RF waveform including, but not limited to, a sinusoidalwaveform.

In another aspect, the pulse generation rate of the acoustic pulses mayrange between about 1 Hz and about 300 Hz. The amplitude or intensity ofthe acoustic pulses generated by the acoustic oscillator may correspondto sonic or ultrasonic oscillations in an additional aspect.

In yet another aspect, the system 100 may further include a pulsemonitoring device (not shown) including, but not limited to: a pulsemonitor mounted to the patient's arm, finger, chest, or other location;an EKG device; an echocardiography device; a blood pressure cuff orother blood pressure sensing device; and any other known pulsemonitoring device. In this aspect, the pulse of the patient may bemonitored by the system 100, and the application of acoustic pulses maybe administered at a pre-determined time before, during, or after aheartbeat of a patient to enhance the effect of the acoustic pulses. Inanother additional aspect, an acoustically conductive gel such as awater-based gel compound may be applied to the patient's skin to enhancethe transmission efficiency of the acoustic pulses to the facial tissuesof the patient.

XI. Administering RF Energy to Tissue at Optimal RF Frequency andOptimal Pulse Frequency

In one embodiment of the system 100 of FIG. 1, the system 100 includesany of the above-described features and further includes a pressure wavesystem or module that is part of the system 100 of FIG. 1 and is usedwith the acoustic oscillator 108. Specifically, the pressure wave modulemay be in addition to or in place of the facial stimulator instrument106 and its supporting apparatus and algorithms. Such a pressure wavesystem or module 5010 is depicted diagrammatically in FIG. 29. In oneembodiment, the pressure wave module 5010 and associated methods includethe delivery of pressure waves (e.g., sound waves) 20 to a patient'sskin tissue (e.g., skin tissue on the patient's face, neck, etc.) 25 inpulses that range in frequency of 1 Hz to 300 Hz for neurologicalstimulation. In other words, in one embodiment, a burst of pressure waveenergy 20 is delivered to the patient's facial target tissue 25.

As can be understood from FIG. 29, which is a schematic diagram of thesystem 5010 being used on the patient 15, the system includes a display5030, an input 5035, a central processing unit (CPU) 5040, a memory5045, and at least one pressure wave (RF energy) generator (e.g., soundwave generator) 108. The display may include a LCD or other type ofscreen for displaying information associated with the use of the system5010 in treating a patient 15. For example, the display 5030 may displaythe patient's age, face, name, medical history, treatment durations,timing sequences, and protocols, and pressure wave shapes, frequencies,etc.

The input 5035 is in electrical communication with the display 5030 andmay include a keyboard, touch screen, mouse, stylus, and/or other typeof input mechanism. The input is configured to receive informationassociated with the treatment of the patient, such as patient age, skintissue condition and location, desired treatment durations, timingsequences, and protocols, etc.

The CPU 5040 is in electrical communication with the display 5030, theinput 5035, and memory 5045. The memory 5045 may include treatmentparameters and protocols associated with the treatment of the patientsuch as, for example, pressure wave types, frequencies, magnitude, etc.for different type of patients, patient skin tissue, and skin tissueconditions.

The pressure wave generating device 108 is in electrical communicationwith the CPU 5040 and is configured to deliver a pressure wave (e.g.,sound wave) to a tissue 25 of the patient 15, such as, for example, theface, neck or other cosmetically treated skin regions of the patient.The pressure wave generating device 108 may be in the form of a handheldwand, as shown, or may be equipped with a strap or other arrangement toallow the pressure wave generating device 108 to be strapped to thepatient 15. The pressure wave generating device 108 may be capable ofgenerating a wide range of pressure energy (e.g., sound energy) 20,including ultrapressure (e.g., ultrasound), and short waves through longwaves. In one embodiment, the pressure energy 20 generated by thepressure wave generating device 108 is a long wave pressure wave.

Typically, a conductive gel is applied to the patient's skin tissue 25to aid in the transmission of the pressure wave to the patient's skinand the underlying tissues and muscle. The pressure wave generatingdevice 108 is configured to deliver a pressure wave having a frequencybetween 500 kHz and 1.5 MHz. In a preferred embodiment, the pressurewave generating device 108 delivers an 800 kHz pressure wave to thepatient 15. Preferably, the pressure wave has sinusoidal waveform,although other waveforms and wave profiles may also be generated.

In various embodiments, the pressure wave generated by the pressure wavegenerating device 108 may be modulated to transmit the pressure wavethroughout the patient's skin and the underlying tissues and muscle. Forexample, the pressure wave may be pulsed at a lower frequency. In oneexample, the pressure wave having a frequency between 500 kHz and 1.5MHz may be pulsed at lower frequency between 1 Hz and to 300 Hz totransmit the energy of a pressure wave in frequencies known to evokeneurological potentials. The pulsing of the wave also reduces heat buildup in the tissues and is intended to maximize the mechanical influenceof the lower frequencies on the tissues and/or nerves.

The CPU 5040 causes the pressure wave-generating device 108 to generatea pressure wave of a desired frequency, magnitude, and duration toachieve neurological stimulation. For example, the pressure wave isachieved by introducing a pulsed pressure wave by pulsing an 800 MHztransmission wave in the frequency range of 1 Hz to 300 Hz in a sweeppattern so as to introduce all frequencies within the range within aprogrammable time period. The pressure wave may be generatedcontinuously and modulated. FIG. 35 illustrates two types of patternsincluding amplitude modulation. Square waves or sinusoidal waves may beprovided by the device.

Various embodiments of the system 5010 may contain more or less featuresaccording to the intended use and/or user of the system. For example,one embodiment of the system 5010 may be configured for home use by apatient. This embodiment of the system 5010 may not have extensivemonitoring equipment. Conversely, another embodiment of the system 100may be provided for clinical use. A clinical embodiment of the system5010 may include all of the monitoring devices described herein, as wellas other monitoring equipment or medical devices as desired by a medicalprofessional. Regardless or whether the device is configured for home orclinical use, the system and method disclosed herein is advantageous inthat it stimulates the nervous system and circulatory system, therebyimproving the function and appearance of patient tissue typically thefocus of health and beauty treatments, such as, for example, the skinand the underlying muscle and tissue of the face, neck, and etc.

In one embodiment, the system and method disclosed herein may includeadministering RF energy to patient tissue at a RF frequency determinedto have the highest transmissibility in the tissue and at a pulsefrequency determined to result in the highest electromyogram reading. Asa result, the administration of the RF energy occurs at a RF frequencythat will cause the RF energy to travel the greatest distance throughthe patient tissue, and the administration of the RF energy will betailored to provide the most beneficial nerve stimulation.

As can be understood from FIG. 29, the system may also include anevaluation RF head 5200, a pressure wave generating device 108, a RFantenna(s) 5210, and an EMG sensor(s) 5215. The pressure wave generatingdevice 108 may be in the form of a plurality 5202 of treatment RF heads5205 a-g. The evaluation RF head 5200 and RF antenna and/or and acousticmeasuring device 5210 are capable of being placed in electricalcommunication with the CPU 5040.

As illustrated in FIG. 30, which is a schematic diagram of the system5010 employing the evaluation RF head 5200 and the RF antenna(s) 5210,the evaluation RF head 5200 includes an array 5203 of piezoelectrictransducers 5220 a-e electrically coupled to a multi-plexer or pulsecontrol 5225 that is electrically coupled to an automatic gain controlamplifier 5230 electrically coupled to a sweep oscillator generator5235. The evaluation RF head 5200 is electrically coupled to acomparator 5237 that is electrically coupled to the CPU 5040 and display5030.

Each piezoelectric transducer 5220 a-e of the array 5203 is individuallytuned to generate RF energy at a distinct frequency as compared to theother piezoelectric transducers of the array. The piezoelectrictransducers 5220 a-e forming the array 5203 of the evaluation RF head5200 provide a range of distinct RF energy frequencies over a range ofbetween approximately 500 KHz and approximately 1.5 MHz at steps ofbetween approximately 50 KHz and approximately 200 KHz. For example, afirst piezoelectric transducer 5220 a may be tuned to 500 KHz, thesecond piezoelectric transducer 5220 b may be tuned to 600 KHz, and soforth through the rest of the piezoelectric transducers such that thearray 5203 is capable of providing RF energy at a frequency range ofbetween approximately 500 KHz and 1.5 MHz with steps of 100 KHz,resulting in an array 5203 having 11 individually tuned piezoelectrictransducers. Thus, the array 5203 is configured to generate RF energyover a range of frequencies not possible via a single piezoelectrictransducer.

As can be understood from FIG. 30, the RF receiver antenna(s) 5210 iselectrically coupled to a bandpass filter 5240 that is electricallycoupled to a linear amplifier 5245 electrically coupled to a leveldetector 5250 electrically coupled to the comparator 5237. As indicatedin FIGS. 29 and 30, the evaluation RF head 5200 is applied to patienttissue, and the RF receiver antenna(s) and or acoustic measuringdevice(s) 5210 is applied to another region of patient tissue at adifferent location spaced apart from the location wherein the head 5200is being applied to the patient tissue. The RF receiver antenna(s) isconfigured to detect RF energy transmitted through the patient tissuefrom the evaluation RF head 5200. For example, as indicated in FIG. 29,where the tissue target location for the administration of the treatmentis crow's feet wrinkles near the lateral edges of the patient's eyes, RFreceiver antennas 5210 could be attached to the patient's skin on theforehead above the eyebrow and on the cheek below the eye.

When the evaluation RF head 5200 and RF receiver antenna(s) 5210 areapplied to the patient tissue, the system 5010 is configured to causethe evaluation RF head 5200 to administer RF energy to the patienttissue over a range of RF frequencies by the sweep oscillator generator5235 generating a series of frequencies in a step fashion across therange of frequencies of the array 5203 and the multi-plexer 5225 sendingthe appropriate stepped frequency to the appropriate piezoelectrictransducer 5220 a-5220 e when said appropriate stepped frequency isgenerated by the oscillator generator 5235. As the array 5203 of thehead 5200 sweeps through the various frequencies, the RF receiverantenna(s) 5210 senses the administered RF energy transmitted throughthe patient. The comparitor 5237, in conjunction with the CPU 5040,identifies which RF frequency of the range of RF frequenciesadministered to the patient via the array 5203 of the head 5200 has themost transmissibility through the patient. The system 5010, via, forexample, the display 5030, recommends a treatment RF head from theplurality 5202 of treatment RF heads 5205 a-5205 e that is capable ofproviding the identified RF frequency.

Each treatment RF head 5205 a-5205 e of the plurality 5202 treatment RFheads shown in FIG. 29 has a piezoelectric transducer tuned to a uniquefrequency different from those of the other heads 5205 a-5205 e. Thus,the plurality 5202 of treatment heads 5205 a-5205 e may be made up of asufficient variety of treatment RF heads so as to cover a range of RFfrequencies in a stepped fashion. For example, treatment RF head 5205a-5205 e of the plurality 5202 is individually tuned to generate RFenergy at a distinct frequency as compared to the other heads 5205a-5205 e of the plurality 5202. The heads 5205 a-5205 e of the plurality5202 provide a range of distinct RF energy frequencies over a range ofbetween approximately 500 KHz and approximately 1.5 MHz at steps ofbetween approximately 50 KHz and approximately 200 KHz. For example, thefirst treatment RF head 5205 a may have a piezoelectric transducer tunedto 500 KHz, the second treatment RF head 5205 b may have a piezoelectrictransducer 5300 may be tuned to 600 KHz, and so forth through the restof the treatment RF heads such that the plurality 5202 of treatmentheads 5205 a-5205 e is capable of providing RF energy at a frequencyrange of between approximately 500 KHz and 1.5 MHz with steps of 100KHz, resulting in plurality 5202 having 11 individually tuned treatmentRF heads. Thus, a treatment RF head 5205 a-5205 e can be selected fromthe plurality 5202 to match the RF frequency identified via the array5203 and comparator 5237 as discussed above with respect to FIG. 29.

Once a treatment RF head 5205 a-5205 e is selected from the plurality5202 that matches the identified RF frequency, the selected RF treatmenthead is electrically coupled to the system 5010, as illustrated in FIG.31. For example, by using the array 5203 and comparator 5237 asdescribed above with respect to FIG. 29, it is determined that afrequency of 600 KHz has the greatest transmissibility through thepatient tissue 25 and, as a result, the system 5010 recommends from theplurality 5202 of heads the treatment RF head 5205 b, which is tuned tooperate at 600 KHz. As shown in FIG. 31, the treatment RF head 5205 b iselectrically coupled to the system 5010, and the EMG sensor(s) 5215 iselectrically coupled to the system 5010. The treatment RF head 5205 band EMG sensor(s) 5215 are both applied to the patient tissue 25.

The system 5010 now appears as schematically depicted in FIG. 32.Specifically, the selected treatment RF head 5205 b includespiezoelectric transducer 5300 electrically coupled to a pulse control5225 that is electrically coupled to a pulse amplifier 5230 electricallycoupled to a sweep oscillator generator 5235. The treatment RF head 205b is electrically coupled to a comparator 5237 that is electricallycoupled to the CPU 5040 and display 5030 described above with respect toFIG. 29.

As can be understood from FIG. 32, the EMG sensor 5215, which haselectrodes, is electrically coupled to a bandpass filter 5240 that iselectrically coupled to a linear amplifier 5245 electrically coupled toa level detector 5250 electrically coupled to a comparator 5237. Asindicated in FIGS. 31 and 32, the treatment RF head 5205 b is applied topatient tissue 25, and the EMG sensor(s) 5215 is applied to patienttissue 25 at a different location spaced apart from the location whereinthe head 5205 b is being applied to the patient tissue. The EMGsensor(s) is configured to detect electromyogram in the patient tissue25 from resulting from RF energy administered to the patient tissue viathe treatment RF head 5205 b. For example, as indicated in FIG. 31,where the tissue target location for the administration of the treatmentis crow's feet wrinkles near the lateral edges of the patient's eyes,EMG sensors 5215 could be attached to the patient's skin on the foreheadabove the eyebrow and on the cheek below the eye.

When the treatment RF head 5205 b and EMG sensor(s) 5215 are applied tothe patient tissue, the system 5010 is configured to cause the treatmentRF head 5205 b to administer RF energy to the patient tissue at theidentified RF frequency (which is 600 KHz in this example) over a rangeof pulse frequencies by the sweep oscillator generator 5235 and pulsecontrol 5225 causing the administered 600 KHz RF energy to pulse at aseries of frequencies in a step fashion across a range of pulsefrequencies generated by the oscillator generator 5235. In oneembodiment, the generator 5235 is configured to cause the treatment RFhead 5205 b to administer RF energy at the identified RF frequency(which is 600 KHz in this example) to the patient over a range of pulsefrequencies between approximately 1 Hz and approximately 300 Hz at stepsthat are defined in the software via an algorithm that allows the userto determine the scan time, in one embodiment, between approximately 1Hz and approximately 30 Hz. Optimum scan times are established for eachtissue type and/or face, neck, etc. region in a database from empiricaldata. For example, a database contained in the memory of the system canbe used to pre-select scan times based on the tissue or area of concernentered into the interface of the system, each tissue type or area ofconcern being correlated in the data base to specific scan times.

As the generator 5235 causes the head 5205 b to sweep through thevarious frequencies, the EMG sensor(s) 5215 senses the resultingelectromyogram in the patient. The comparitor 5237, in conjunction withthe CPU 5040, identifies which pulse frequency of the range of pulsefrequencies administered to the patient via the generator 5235 and head5205 b has the highest electromyogram reading in the patient. The system5010, via, for example, the display 5030, recommends a treatment pulsefrequency setting from the plurality of treatment pulse frequenciesavailable to the treatment head 5205 b via the generator 5235. Forexample, the EMG sensor and comparitor work together to determine apulse frequency of 20 Hz resulted in the highest electromyogram readingsin the patient. Accordingly, the system 5010 recommends using thetreatment RF head 5205 b to administer 600 KHz RF energy at a 20 Hzpulse frequency (i.e., the 600 KHz RF energy is pulsed at 20 Hz whenbeing administered to the patient tissue). FIG. 34 illustrates a graphof RF energy being administered at the identified (optimum) RF frequencyof 600 KHz and pulsed at the identified (optimum) pulse frequency of 20Hz, as used in this example. FIG. 35 is an example of a pulsed outputsignal similar to that depicted in FIG. 34. FIG. 36 is an example of amodulated output signal. In some embodiments of the system, the RFenergy can be administered at an identified (optimum) RF frequency(e.g., 600 Hz) and pulsed at the identified (optimum) pulse frequency(e.g., 20 Hz) such that the RF energy is pulsed similar to that depictedin FIG. 35. In some embodiments, the RF energy at the identified RFfrequency may be modulated at the identified pulse frequency similar tothat depicted in FIG. 36.

As can be understood from the preceding discussion regarding FIGS.29-32, a method is disclosed herein where RF energy is applied to thepatient tissue at a more transmissible RF frequency and at a pulsefrequency that results in the highest electromyogram readings. Forexample, as can be understood from FIG. 33, via the transducer array5203 of the evaluation RF head 5200, RF energy is administered to thepatient over a range of RF frequencies [block 6000]. Via the RF receiverantenna and/or acoustic measuring device(s) 5210, the administered RFenergy is detected [block 6005]. The CPU 5040 and comparator 5237identifying which RF frequency of the range of RF frequencies has thegreatest transmissibility through the patient [block 6010]. The display5030 recommends the identified RF frequency for use in further RF energytreatment to the patient [block 6015]. The applicable treatment RF head5205 b corresponding to the identified RF frequency is selected from theplurality 5202 of heads and coupled to the system 5010 [block 6020].Baseline electromyography readings are taken of the patient via the EMGsensor(s) 5215 [block 6022] followed by using the selected treatment RFhead 5205 b to administer to the patient the RF energy at the identifiedRF frequency over a range of pulse frequencies [block 6025]. The EMGsensor(s) 5215, the comparator 5237 and CPU 5040 are used to identifythe pulse frequency of the range of pulse frequencies resulting in thehighest electromyogram readings in the patient [block 6030], and thedisplay 5030 recommends the identified pulse frequency for use infurther RF energy treatment to the patient [block 6035]. The selectedtreatment RF head 5205 b is then used to administer the RF energy at theidentified RF frequency and identified pulse frequency to the patient[block 6040].

While the system embodiment discussed above with respect to FIGS. 29-33applies to patient tissue RF energy at an identified RF frequency andidentified pulse frequency, in some embodiments, the system 5010 willapply an identified RF frequency over a range of stepped amplitudesinstead of over a range of stepped pulse frequencies. Accordingly, oncea specific stepped amplitude is identified as resulting in the highestEMG reading, the RF energy can be applied to the patient tissue at theidentified RF frequency and identified amplitude.

By administering the RF energy to the patient tissue at an identified RFfrequency and identified pulse frequency, the RF energy can be tailoredto travel the greatest distance possible through the patient tissue at apulse frequency that provides the greatest therapeutic result, asindicated by the EMG sensor readings, which give an instantaneousfeedback of the therapeutic impact of the RF energy, such instantaneousfeedback being less likely to be obtained via tissue temperaturereadings, tissue oxygenation readings, or other measurements. Over timeand the course of treatment via the system 10, the patient tissuecharacteristics may change with respect to the RF frequency and/or thepulse frequency believed to be optimal for the therapeutic affect.Accordingly, the methodology outlined in FIG. 33 can be reapplied toidentify a new optimal RF frequency, which will require the selection ofa new treatment RF head from the plurality of such heads. Also, the newtreatment RF head and above described methodology can be used toidentify a new optimal pulse frequency. The system can then be used toadminister the RF energy to the patient tissue at the new optimal RF andpulse frequencies.

Applying the pulsed RF energy to the patient tissue is advantageous inthat it creates corresponding waves that travel through the patienttissue to release their energy at boundary layers such as, for example,facia, muscle, tendons or bone, etc. that are highly innervated. Thisrelease of mechanical energy at the boundary layers stimulates thenervous and vascular system, thereby providing a therapeutic benefit fortissues typically the focus of traditional health and beauty treatments.Pulsing the RF energy at the optimal RF frequency also reduces tissueheating as compared to continuously applied RF energy at the optimal RFfrequency.

The embodiments of the system discussed above with respect to FIGS. 1-36can also be employed as depicted in the diagrams of FIGS. 37 and 38,wherein the system may employ a portion for use by the physician at theclinic (i.e., a clinic portion) and a portion for use back at thepatient home (i.e., a home-use portion). Specifically, the clinicportion is used by the physician at the clinic to diagnose the patient,formulate a treatment for the patient, treat the patient, and storetreatment data associated with the actual treatment of the patient. Thehome-use portion is provided with the formulated treatment and,possibly, the stored treatment data and sent back to the patient homewith the patient so treatment can be continued at the patient homewithout having to return to the clinic. For example, data and treatmentinformation may be downloaded from the clinic portion into the home-useportion. In one embodiment, the clinic portion may be configured likeany of the embodiments of the system discussed above, and the home-useportion may similarly configured but be in a more portableconfiguration, perhaps have fewer features as a result, and be capableof establishing a data link with the clinic portion.

As can be understood from FIGS. 37-38, in one embodiment, the home-useportion 400 and the clinic portion 410 may connect via the data link420. The data 420 link may comprise a connection between the home-useportion 400 and the clinic portion 410 capable of uploading datarelating to the operation and/or results of the treatment carried out onthe home-use portion 400. The data link 420 may comprise any means forconnecting the home-use portion 400 to the clinic portion 410 or aserver, file storage system, or database that is readable by the clinicportion 410. For example, as indicated in FIG. 37, the data link maycomprise a network connection 430 such as an Ethernet or Wi-Ficonnection, a cellular connection, or any other network connection, andmay connect to the clinic portion 410 either directly or through anintermediary such as over the Internet or any other network. The datalink 420 may then upload operation and/or results data to the clinicportion for analysis.

In various embodiments, the data link 420 may comprise an I/O portcapable of communicating with an intermediary device 440 that is incommunication with the clinic portion 410. For example, as illustratedin FIG. 38 the intermediary device 440 may comprise a portable datastorage device capable of being physically transported to the clinicportion 410 or connected to a device in electrical communication withthe clinic portion 410. This may include a universal serial bus (USB)port connected to a USB drive, such as a conventional USB flash drive,external hard drive, or other USB enable storage device. The USB drivemay be connected to the home-use portion 400 and may receive datarelated to the operation and/or results of treatments carried out on thehome-use portion 400 from the data link 420. The USB drive may then bephysically taken to the location of clinic portion 410 and the datauploaded via the data link 420 onto the clinic portion 410. In variousother embodiments, the USB drive may be connected to a home computer orany other Internet-enabled device and the data may be uploaded to theclinic portion 410.

In various embodiments, the data link 420 may be configured toautomatically send the operation and/or results data to the clinicportion. This may be done every time the home-use portion has completedtreatment, at set time intervals, upon the request of the clinicportion, or according to the treatment results. For example, the datalink may automatically upload the operations and/or results data at theend of every week. In another example, the data link may automaticallyupload the operations and/or results data when a result exceeds athreshold in some way. This may include one of many relevantcomparisons. For example, besides tracking the user's treatment results,the home-use portion also may keep track of average results and standarddeviation. If a user's results are unsatisfactory on average for aperiod of time, then modifications may be needed and the user'streatment and the data link may automatically send the operation and/orresults data to the clinic portion regarding the poor results average.Similarly, if the user experiences outlier results that are outside of aset number of standard deviations from average, then the results may beuploaded. In the case of a non-network connected communications link,the user may be prompted by the home-use system to connect theintermediary device and either upload the data to the clinic portion orto take the intermediary device to their physician.

The foregoing merely illustrates the principles of the invention.Various modifications and alterations to the described embodiments willbe apparent to those skilled in the art in view of the teachings herein.It will thus be appreciated that those skilled in the art will be ableto devise numerous systems, arrangements and methods which, although notexplicitly shown or described herein, embody the principles of theinvention and are thus within the spirit and scope of the presentinvention. From the above description and drawings, it will beunderstood by those of ordinary skill in the art that the particularembodiments shown and described are for purposes of illustrations onlyand are not intended to limit the scope of the present invention.References to details of particular embodiments are not intended tolimit the scope of the invention.

XII. Procedure for Administering Facial Treatment

In one embodiment, the system 100 is configured to apply therapy to thetrigeminal nerve, certain connecting points of the facial muscles, andfacial skin and muscles at certain facial landmarks and locations. Whilethis therapy is described below as taking place in an order wherein thetrigeminal nerve exit points are first measured and treated followed bythe facial muscle connecting points and the facial skin and muscles,these measurements and therapies may occur in any order. Additionally,while this therapy is described below as taking place in order whereinthe force impulse production procedure is first performed followed bythe acoustic oscillator procedure, these therapies may occur in anyorder.

a. Force Impulse Production

As can be understood from the flow chart illustrated in FIG. 39, thetrigeminal nerve exit points 4201-4208 depicted in FIG. 42, and theanatomical depiction of the trigeminal nerve illustrated in FIG. 43, inone embodiment, an exit point of the trigeminal nerve (e.g., 4201) isselected from several of such exit points (e.g., 4201-4208) [block3901]. A practitioner can locate the nerve exit points (e.g., 4201),among other techniques, by palpitating the facial area adjacent therespective nerves. If a resultant waveform has not been previouslymeasured and stored, the piezoelectric analysis/treatment head 2202 isthen used to measure a resultant waveform from the selected exit point[block 3903A] of the trigeminal nerve by applying a percussive impactforce onto the facial tissue immediately adjacent the trigeminal nerveand sensing the resultant waveform with the piezoelectric sensor 2206.The impact on the facial tissue produces a force impulse which travelsthrough the piezoelectric sensor 2206 and causes the piezoelectricsensor 2206 to generate a waveform, which is stored [block 3903C] in thesystem 100. Alternatively, if the waveform has been previously measuredand stored, the system 100 can retrieve the stored waveform [block3903B]. From the resultant waveform, the system 100 calculates theresonate frequency and sub harmonic frequencies of the selected exitpoint [block 3904]. Additionally or alternatively, the system 100 canstore resonate, fundamental, and other frequencies.

The piezoelectric analysis/treatment head 2202 can then be used to treatthe selected exit point of the trigeminal nerve with the calculated subharmonic frequencies [block 3905]. Specifically, in one embodiment, thetreatment may be in one frequency range. Additionally or alternatively,the treatment may be a stepped frequency that steps through each subharmonic within each range. Further, additionally or alternatively, thetreatment may be a sweeping mode at programmable intervals. In oneembodiment, one or more of the following sub harmonic frequency rangesare employed in the treatment of the exit point via the system 100: 0.1to 3.99 Hz; 4 to 6.99 Hz; and 7 to 12 Hz. Once the treatment of theselected exit point (e.g., 4201) is complete, the system 100 asks ifadditional exit points exist that have yet to be treated [block 3906],and if the answer is “yes”, then the system returns to the operation ofblock 3901 to start over at a new exit point (e.g., 4202) and repeat theprocess as outlined in blocks 3901 through 3907 until all exit points(e.g., 4201-4208) have been measured and treated. If the answer is “no”,then the system 100 ends this part of the treatment methodology [block3907].

In one embodiment, the system 100 is then used to apply therapy tocertain connecting points of the facial muscles (e.g., 4401 through44055). For example, as can be understood from the flow chartillustrated in FIG. 40 and the anatomical depiction of the facial muscleconnecting points illustrated in FIG. 44, in one embodiment, aconnecting point of a facial muscle (e.g., 4401) is selected fromseveral of such connecting points (e.g., 4401 through 4405) [block4001]. A practitioner can locate the muscle connecting points (e.g.,4401), among other techniques, by palpitating the facial area. If aresultant waveform has not been previously measured and stored, thepiezoelectric analysis/treatment head 2202 is then used to measure aresultant waveform from the selected connecting point [block 4003A] ofthe facial muscle by applying a percussive impact force onto the facialtissue immediately adjacent the connecting point and sensing theresultant waveform with the piezoelectric sensor 2206. The impact on thefacial tissue produces a force impulse which travels through thepiezoelectric sensor 2206 and causes the piezoelectric sensor 2206 togenerate a waveform, which is stored [block 4003C] in the system 100.Alternatively, if the waveform has been previously measured and stored,the system 100 can retrieve the stored waveform [block 4003B]. From theresultant waveform, the system 100 calculates the resonate frequency andsub harmonic frequencies of the selected connecting point [block 4004].Additionally or alternatively, the system 100 can store resonate,fundamental, and other frequencies.

The piezoelectric analysis/treatment head 2202 can then be used to treatthe selected connecting point of the facial muscle with the calculatedsub harmonic frequencies [block 4005]. Specifically, in one embodiment,the treatment may be in one frequency range. Additionally oralternatively, the treatment may be a stepped frequency that stepsthrough each sub harmonic within each range. Further, additionally oralternatively, the treatment may be a sweeping mode at programmableintervals. In one embodiment, one or more of the following sub harmonicfrequency ranges are employed in the treatment of the connecting pointvia the system 100: 0.1 to 3.99 Hz; 4 to 6.99 Hz; and 7 to 12 Hz. Oncethe treatment of the selected connecting point (e.g., 4401) is complete,the system 100 asks if additional connecting points (e.g., 4402-4405)exist that have yet to be treated [block 4006], and if the answer is“yes”, then the system 100 returns to the operation of block 4001 tostart over at a new connecting point and repeat the process as outlinedin blocks 4001 through 4007 until all connecting points have beenmeasured and treated. If the answer is “no”, then the system 100 endsthis part of the treatment methodology [block 4007].

b. Acoustic Oscillator (RF Generator Modulated by Acoustic (Audio)Modulator)

In one embodiment, as discussed below with respect to the flow chartdepicted in FIG. 41, the system 100 is then used to stimulate the skinand muscles of certain areas of the face. For example, the system 100may be used to stimulate the face at certain areas such as the corner ofthe eyes, the corners of the mouth, the forehead, and the creases oneither side of the nose and jawline. In one embodiment, screen promptson the graphical user interface are initially provided on the display112 of the system 100. These screen prompts can be followed in using anappropriate treatment RF head 5205 a-5205 e from the plurality 5202 oftreatment RF heads shown in FIG. 29 and as per the procedure outlined inFIG. 33, to stimulate the certain skin and muscles areas. Examples ofsuch treatment areas of the face are the corner of the eyes, the cornersof the mouth, the forehead, and the creases on either side of the noseand jawline.

As illustrated in FIG. 41, a first area of the facial muscles and skinis selected for measurement and treatment from a group of such areas[block 4101]. The stored waveform from a previous therapy that utilizeda piezoelectric treatment head 2202 can be retrieved [block 4103B] or aresultant waveform can be measured [block 4103A] as in the previoussection through force impact production with a piezoelectric treatmenthead 2202. From the resultant waveform, either previously stored [block4103B] or measured [block 4103A], the system 100 calculates the resonatefrequency and sub harmonic frequencies of the first selected area of thefacial muscles and skin [block 4004]. Additionally or alternatively, thesystem 100 can store resonate, fundamental, and other frequencies.

The calculated harmonic and sub harmonic frequencies are used to programthe pulse rate of the treatment RF head 5205 a-5205 e [block 4105]. Thispulse rate can be a fixed value of the measured frequency. Alternativelyor additionally, the pulse rate can be a sub harmonic. Also,alternatively or additionally, the pulse rate can be a stepped frequencythat switches between a base frequency and sub harmonics. Finally,alternatively or additionally, the pulse rate can be a sweeping modethat pulses between a harmonic and sub harmonic modes at programmableintervals.

The certain skin and muscle areas of the face may be treated by applyingpulsed sub harmonic frequencies to selected areas of a patient in therange of: 0.1 to 3.99 Hz; 4 to 6.99 Hz; and 7 to 12 Hz [block 4106]. Inone embodiment, the carrier frequency will be in the range ofapproximately 500 MHZ to approximately 1000 MHz. This treatment can beone frequency range. Alternatively or additionally, the treatment can bestepped frequency that steps through each sub harmonic within eachrange. Finally, alternatively or additionally, the treatment can be asweeping mode at programmable intervals.

Once the treatment of the certain skin and muscle areas of the face iscomplete, the system 100 asks if additional certain skin and muscleareas of the face exist that have yet to be treated [block 4107], and ifthe answer is “yes”, then the system 100 returns to the operation ofblock 4101 to start over at a new certain skin and muscle area of theface and repeat the process as outlined in blocks 4101 through 4106until all certain skin and muscle areas of the face have been measuredand treated. If the answer is “no”, then the system 100 ends this partof the treatment methodology [block 4108].

In one embodiment, the piezoelectric head 2202 of the system 100 is usedto measure and store frequency information about two distinct aspects ofa patient's face, namely, the exit points of the trigeminal nerve andthe facial muscle attachment points. This measured and stored frequencyinformation is then used by the system in the treatment of the patient'sface (e.g., the trigeminal nerve exit points and the facial muscleattachment points) via other treatment devices of the system 100 suchas, for example, the RF head 5205 a-5205 e of the system.

In one embodiment, the piezoelectric head 2202 of system 100 is used tocalculate base and sub harmonic frequencies for use in the RF head 5205a-5205 e to program the pulse rate of the RF head 5205 a-5205 e. Thispulse rate can be a fixed frequency of the true harmonic. Alternativelyor additionally, the pulse rate can be a sub harmonic. Also,alternatively or additionally, the pulse rate can be a stepped frequencythat switches between harmonic and sub harmonics. Finally, alternativelyor additionally, the pulse rate can be a sweeping mode that pulsesbetween harmonic and sub harmonic modes at programmable intervals.

In one embodiment, the RF head 5205 a-5205 e will have a pre-loadfunction that will ensure that the RF head is in adequate contact withthe skin before the power is turned on to promote proper usage of thesystem 5010.

What is claimed is:
 1. A system for cosmetically treating tissue of apatient for at least one of improving skin appearance, reducing skinwrinkles, improving skin tone, or improving tissue function, the systemcomprising: a display including a LCD or other type of screen andconfigured to display information associated with the treatment of thetissue; an input in electrical communication with the display andincluding a key board, touch screen, or other type of input mechanism,the input configured to receive information associated with thetreatment of the tissue; a CPU in electrical communication with theinput; a memory in electrical communication with the CPU and includingtreatment parameters associated with the treatment of the tissue; afirst RF head capable of being placed in electrical communication withthe CPU and comprising an array of piezoelectric transducers, the arrayconfigured to generate RF over a range of frequencies not possible via asingle piezoelectric transducer; and a RF receiver antenna capable ofbeing placed in electrical communication with the CPU and configured todetect RF energy transmitted through the tissue from the first RF head;a plurality of second RF heads, each second RF head having apiezoelectric transducer tuned to a unique frequency and capable ofbeing placed in electrical communication with the CPU; and an EMG sensorcapable of being placed in electrical communication with the CPU andconfigured to detect electromyogram in the tissue; wherein, when thefirst RF head and RF receiver antenna are applied to the tissue, thesystem is configured to: a) cause the first RF head to administer RFenergy to the tissue over a range of RF frequencies; b) cause the RFreceiver antenna to sense the administered RF energy transmitted throughthe tissue; c) identify which RF frequency of the range of RFfrequencies administered to the tissue has the most transmissibilitythrough the tissue; and d) recommend a second RF head of the pluralityof RF heads that is capable of providing the identified RF frequency,wherein, when the recommended second RF head and EMG sensor are appliedto the tissue, the system is configured to: a) cause the recommendedsecond RF head to administer RF energy at the identified RF frequency tothe tissue over a range of pulse frequencies; b) cause the EMG sensor todetect electromyogram in the tissue arising due to the RF energyadministered to the tissue over the range of pulse frequencies; c)identify which pulse frequency of the range of pulse frequenciesadministered to the tissue causes the highest electromyogram readings inthe tissue; and d) treat the tissue with the recommended second RF headat the identified RF frequency at the identified pulse frequency.
 2. Thesystem of claim 1, wherein the array is configured to generate RF over arange of between approximately 500 KHz and approximately 1.5 MHz.
 3. Thesystem of claim 2, wherein the array is configured to generate RF over arange of between approximately 500 KHz and approximately 1.5 MHz atsteps of between approximately 50 KHz and approximately 200 KHz.
 4. Thesystem of claim 1, where the piezoelectric transducers of the arrayincludes a first piezoelectric transducer, a second piezoelectrictransducer, and a third piezoelectric transducer, wherein each of thefirst, second and third piezoelectric transducers generate RF atdistinct frequencies from each other.
 5. The system of claim 1, whereinthe plurality of second RF heads includes individual second RF headseach tuned to a unique frequency from each other and each uniquefrequency is between approximately 500 KHz and approximately 1.5 MHz. 6.The system of claim 1, wherein, when the recommended second RF head iscaused to administer RF energy at the identified RF frequency to thepatient over a range of pulse frequencies, range of pulse frequencies isbetween approximately 1 Hz and approximately 300 Hz.
 7. The system ofclaim 6, wherein the recommended second RF head is caused to administerRF energy at the identified RF frequency to the patient over the pulsefrequency range of between approximately 500 KHz and approximately 1.5MHz at steps programmatically controlled and optimized for tissue typevia stored protocols.
 8. The system of claim 1, further comprising animpulse head capable of being placed in electrical communication withthe CPU and including a solenoid driven anvil configured to delivermechanical impulse energy to the tissue, the impulse head furtherincluding a transducer sensor for detecting a wave generated in thetissue via the administration of the mechanical impulse energy to thetissue.
 9. The system of claim 1, further comprising an electrodecapable of being placed in electrical communication with the CPU andconfigured to administer electrical stimulation to the tissue and readelectrical characteristics of the tissue in response to the electricalstimulation.
 10. The system of claim 9, wherein the electrode issupported on the impulse head.
 11. The system of claim 1, furthercomprising a camera capable of being placed in electrical communicationwith the CPU and configured to take images of the tissue, the systembeing configured to compare images of the tissue taken pre and posttreatment via the system.
 12. A method for cosmetically treating tissueof a patient for at least one of improving skin appearance, reducingskin wrinkles, improving skin tone, or improving tissue function, themethod comprising: administering RF energy to the tissue over a range ofRF frequencies; detecting the administered RF energy; identifying whichRF frequency of the range of RF frequencies has the greatesttransmissibility through the tissue; recommending the identified RFfrequency for use in further RF energy treatment to the tissue;administering the RF energy at the identified RF frequency to the tissueover a range of pulse frequencies; identifying which pulse frequency ofthe range of pulse frequencies results in the highest electromyogramreadings in the tissue; recommending the identified pulse frequency foruse in further RF energy treatment to the tissue; and administering theRF energy at the identified RF frequency and identified pulse frequencyto the tissue.
 13. The method of claim 12, wherein the administration ofthe RF energy to the tissue over the range of frequencies isaccomplished via a RF head having an array of piezoelectric transducerseach tuned to an individual unique frequency, the array being configuredto generate RF over a range of between approximately 500 KHz andapproximately 1.5 MHz.
 14. The method of claim 12, wherein theadministration of the RF energy to the tissue over the range offrequencies is over a range of between approximately 500 KHz andapproximately 1.5 MHz at steps of between approximately 50 KHz andapproximately 200 KHz.
 15. The method of claim 12, wherein therecommending the identified RF frequency for use in further RF energytreatment to the tissue includes identifying a specific RF head from aplurality of RF heads that is configured to provide the recommended RFfrequency.
 16. The method of claim 12, wherein the administering the RFenergy at the identified RF frequency to the tissue over a range ofpulse frequencies occurs over a pulse frequencies ranging betweenapproximately 1 Hz and approximately 300 Hz programmatically controlledand optimized for tissue type via stored protocols.
 17. The method ofclaim 12, wherein the administering the RF energy at the identified RFfrequency to the patient over a range of pulse frequencies occurs over apulse frequencies ranging between approximately 1 Hz and approximately30 Hz.
 18. A system for treating a facial tissue of a patient, thesystem comprising: a display and an input device; at least one camera;at least one instrument chosen from: a facial stimulator instrument to:apply a percussive massage comprising one or more force impulses and/oran electrical stimulation comprising one or more electrical pulses tothe facial tissue; and measure a response of the facial tissue to one ofthe applied force impulses or to one of the applied electrical pulses toassess a condition of the facial tissue; and an acoustic oscillator toapply an acoustic stimulation comprising one or more acoustic pulses tothe facial tissue; at least one processor; a database comprising: atleast one stored treatment protocol; and stored patient data comprisingat least one stored facial image; and at least one patient-specifictreatment protocol; and at least one measurement-correlated instrumentcontrol setting; a facial treatment application executed by theprocessor to: obtain at least one facial image using the at least onecamera; assess the symmetry of one or more facial landmarks from the atleast one facial image; select a treatment protocol comprising one ormore instrument control settings, and one or more facial landmarks to betreated; implement one or more treatments to the facial tissue accordingto one or more selected treatment protocols by operating the at leastone instrument using a graphical display to guide an operator of thesystem through the treatment of the one or more facial landmarks,wherein the one or more treatments are chosen from: a neural treatmentcomprising one or more percussive massages and/or one or more electricalstimulations to one or more facial landmarks associated with facialnerves; a muscular treatment comprising one or more percussive massagesand/or one or more electrical stimulations to one or more faciallandmarks associated with facial muscles; and a circulatory treatmentcomprising one or more acoustic stimulations to one or more faciallandmarks associated with facial circulatory vessels.
 19. The system ofclaim 18, wherein the input device is a touch-screen device.
 20. Thesystem of claim 18, wherein the at least one facial image is a 2D imageor a 3D image.
 21. The system of claim 20, wherein the at least onestored facial image comprises at least one facial image, one or morefacial landmarks from the facial image, and an asymmetry of each faciallandmark assessed by the facial treatment application.
 22. The system ofclaim 21, wherein the at least one stored facial image comprises a firstfacial image obtained before the implementation of the one or moretreatments to the facial tissue and a second facial image obtained afterthe implementation of the one or more treatments to the facial tissue.23. The system of claim 18, wherein the at least one stored treatmentprotocol comprises at least one entry, each of the at least one entriescomprising a diagnosis of a facial tissue disorder and a treatmentprotocol associated with the diagnosis.
 24. The system of claim 18,wherein the treatment protocol is selected by one of: selecting one ofthe stored treatment protocols; selecting one of the patient-specifictreatment protocols; selecting a treatment protocol based on a tissuedisorder identified by the assessment of the symmetry of the one or morefacial landmarks of the facial image; and manually entering thetreatment protocol via the input device.
 25. The system of claim 18,wherein the instrument control settings comprise at least one of:percussive massage control parameters chosen from a frequency ofproduction of the one or more force impulses, a peak force of each ofthe one or more force impulses, and a duration of the percussivemassage; electrical stimulation control parameters chosen from afrequency of production of the one or more electrical pulses, a waveformof each of the one or more electrical pulses, a peak current or voltageof each of the one or more electrical pulses, a frequency of each of theone or more electrical pulses, and the duration of the electricalstimulation; and acoustic stimulation control parameters chosen from awave type of each of the one or more acoustic pulses, a frequency ofeach of the one or more acoustic pulses, an amplitude of each of the oneor more acoustic pulses, a frequency of production of acoustic pulses,and the duration of the acoustic stimulation.
 26. The system of claim25, wherein the frequency of production of the one or more forceimpulses ranges between about 0.1 Hz and about 12 Hz.
 27. The system ofclaim 25, wherein the frequency of production of the one or moreelectrical pulses ranges between about 0.1 Hz and about 150 Hz.
 28. Thesystem of claim 25, wherein the waveform of each of the one or moreelectrical pulses is chosen from high voltage mono-phasic, high voltagebi-phasic, Russian symmetrical bi-phasic, square wave mono-phasic,square wave bi-phasic, and any combination thereof.
 29. The system ofclaim 25, wherein the frequency of production of the one or moreacoustic pulses ranges between about 1 Hz and about 300 Hz.
 30. Thesystem of claim 25, wherein the frequency of each of the one or moreacoustic pulses ranges between about 500 kHz and about 1.5 MHz.
 31. Thesystem of claim 18, wherein the graphical display used to guide theoperator of the system through the treatment of the one or more faciallandmarks comprises: one of the facial images overlaid with one or moresymbols, each symbol representing a facial landmark; a list ofinstrument control settings; at least one control button, wherein theselection of one control button on the display implements a treatmentfunction.
 32. The system of claim 31, wherein the one or more symbolsincorporate an indication of a degree of asymmetry of the faciallandmark chosen from a color, a graph, and a numerical overlay.
 33. Thesystem of claim 31, wherein the treatment function of one control buttonis chosen from: starting the treatment of a facial landmark, stoppingthe treatment, restarting the treatment, advancing to a next faciallandmark, editing one of the instrument control settings, and exitingthe graphical display.
 34. The system of claim 18, wherein theimplementation of the one or more treatments further comprises:operating the at least one instrument to measure the response of thefacial tissue; analyzing the response of the facial tissue to estimate acondition of the facial tissue; adjusting one or more of the instrumentcontrol settings based on the estimated condition of the facial tissue.35. The system of claim 34, wherein the response of the facial tissue ischosen from: a waveform of the facial tissue response to the appliedforce impulse chosen from a peak amplitude, a peak time, a rise time, afall time, a frequency, and an area under the wave; and a galvanic skinresponse to the applied electrical pulse.
 36. The system of claim 35,wherein the adjustment of the instrument control settings is performedat one or more discrete times chosen from: prior to the implementationof the one or more treatments, and at a time selected by the operator ofthe system.
 37. The system of claim 35, wherein the adjustment of theinstrument control settings is performed essentially continuously duringthe implementation of the one or more treatments.
 38. A method oftreating a facial tissue of a patient, the method comprising: obtainingat least one facial image using at least one camera; assessing thesymmetry of one or more facial landmarks from the at least one facialimage; selecting a treatment protocol comprising one or more instrumentcontrol settings, and one or more facial landmarks to be treated;implementing one or more treatments to the facial tissue according toone or more selected treatment protocols by operating at least oneinstrument, chosen from a facial stimulator instrument and an acousticoscillator, using a graphical display to guide an operator through thetreatment of the one or more facial landmarks, wherein the one or moretreatments are chosen from: a neural treatment comprising one or morepercussive massages and/or one or more electrical stimulations to one ormore facial landmarks associated with facial nerves; a musculartreatment comprising one or more percussive massages and/or one or moreelectrical stimulations to one or more facial landmarks associated withfacial muscles; and a circulatory treatment comprising one or moreacoustic stimulations to one or more facial landmarks associated withfacial circulatory vessels.
 39. A system for treating a facial tissue ofa patient, the system comprising: memory comprising: at least one storedtreatment protocol; and stored patient data comprising: at least onestored facial image; and at least one patient-specific treatmentprotocol; and at least one measurement-correlated instrument controlsetting; at least one camera; at least one instrument chosen from: afacial stimulator instrument to: apply a percussive massage comprisingone or more force impulses and/or an electrical stimulation comprisingone or more electrical pulses to the facial tissue; and measure aresponse of the facial tissue to one of the applied force impulses or toone of the applied electrical pulses to assess a condition of the facialtissue; and an acoustic oscillator to apply an acoustic stimulationcomprising one or more acoustic pulses to the facial tissue; a pluralityof modules executing on at least one processor, the modules comprising:a treatment protocol selection module to select one or more treatmentprotocols based on at least one of: the stored patient data, an analysisof the condition of the facial tissues, one or more of the storedtreatment protocols, one or more of the stored patient-specifictreatment protocols, and a treatment protocol specified by the operator;a neural treatment module to implement a neural treatment comprising oneor more percussive massages and/or one or more electrical stimulationsto one or more facial landmarks associated with facial nerves; amuscular treatment module to implement a muscular treatment comprisingone or more percussive massages and/or one or more electricalstimulations to one or more facial landmarks associated with facialmuscles; and, a circulatory treatment module to implement a circulatorytreatment comprising one or more acoustic stimulations to one or morefacial landmarks associated with facial circulatory vessels.
 40. Thesystem of claim 39, wherein the treatment protocol selection modulefurther comprises: a stored treatment module comprising: a treatmentprotocol selection module for displaying a menu of stored treatmentprotocols and receiving a selection of a stored treatment protocols fromthe displayed menu; an instrument control settings module forinitializing the control setting of the at least one instrument to theinstrument control settings of the selected stored treatment protocol;and a treatment selection module for initializing the execution of thetreatment module specified by the selected stored treatment protocol; afacial symmetry assessment module comprising: an image acquisitionmodule comprising a camera interface module for obtaining a facial imageusing the camera; an image analysis module for identifying one or morefacial landmarks and assessing the symmetry of the facial landmarks, themodule comprising: a guided image analysis module to display the facialimage, prompt the operator of the system to identify one or more faciallandmarks using a first GUI, and to analyze the symmetry of theoperator-identified facial landmarks; and an automated image analysismodule to automatically identify one or more facial landmarks and toanalyze the symmetry of the identified facial landmarks; a trigger pointanalysis to prompt the operator to obtain additional measurements of thefacial tissues at one or more facial landmarks using the facialstimulator instrument, wherein the additional measurements are chosenfrom: facial tissue response to an applied force impulse and facialtissue response to an applied electrical pulse; a treatment selectionmodule to select one or more treatment protocols based on one or moreof: the analyzed symmetry of one or more facial landmarks and theadditional measurements of the facial tissues; and a facial image storemodule to store a facial image in the one or more stored facial imagesof the stored patient data.
 41. The system of claim 40, wherein theguided image analysis module further comprises: a reference axisassignment module to determine an axis or plane of symmetry for the oneor more facial images; a facial image interface module to display thefirst GUI and to receive the operator inputs via the first GUI; an eyecomparison module to assess the left/right symmetry of facial landmarksassociated with a left eye and a right eye of the patient; an earcomparison module to assess the left/right symmetry of facial landmarksassociated with a left ear and a right ear of the patient; a cheekcomparison module to assess the left/right symmetry of facial landmarksassociated with a left cheek and a right cheek of the patient; a noseassessment module to assess the left/right symmetry of facial landmarksassociated with a nose of the patient; a mouth assessment module toassess the left/right symmetry of facial landmarks associated with amouth of the patient; and a jawline assessment module to assess theleft/right symmetry of facial landmarks associated with a jawline of thepatient.
 42. The system of claim 40, wherein the trigger point analysismodule further comprises: an instrument interface module to guide theoperator through obtaining the additional measurement of a facial tissueresponse using a second GUI display; a signal acquisition module toreceive the additional measurement; a signal analysis module to analyzethe additional measurement and to estimate a condition of the facialtissue; and an instrument control settings module to determine theinstrument control settings for use in the selected treatment protocol.43. The system of claim 39, wherein the neural treatment module furthercomprises: a facial nerve image display module to generate a third GUIfor guiding the operator through the neural treatment; an instrumentconfiguration module to receive and implement the instrument controlsettings; a trigger point frequency analysis module to obtain andanalyze additional measurements of the facial tissues to estimate thecondition of a neural tissue, and to adjust the instrument controlsettings based on the estimated condition of the neural tissue; and aninstrument interface module to receive operator inputs for operating theinstrument via the third GUI to implement the neural treatment.
 44. Thesystem of claim 39, wherein the muscular treatment module furthercomprises: a facial muscle image display module to generate a fourth GUIfor guiding the operator through the muscular treatment; an instrumentconfiguration module to receive and implement the instrument controlsettings; a trigger point frequency analysis module to obtain andanalyze additional measurements of the facial tissues to estimate thecondition of a muscular tissue, and to adjust the instrument controlsettings based on the estimated condition of the muscular tissue; and aninstrument interface module to receive operator inputs for operating theinstrument via the fourth GUI to implement the muscular treatment. 45.The system of claim 39, wherein the circulatory treatment module furthercomprises: a facial circulatory vessel image display module to generatea fifth GUI for guiding the operator through the circulatory treatment;an instrument configuration module to receive and implement theinstrument control settings; a trigger point frequency analysis moduleto obtain and analyze additional measurements of the facial tissues toestimate the condition of a circulatory tissue, and to adjust theinstrument control settings based on the estimated condition of thecirculatory tissue; and an instrument interface module to receiveoperator inputs for operating the instrument via the fifth GUI toimplement the circulatory treatment.